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Somerset, PA 15501
814-443-1319
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Engineering
Civil Engineering
Mechanical Engineering
Municipal Engineering
Building Design
Renewable Energy
Surveying
Construction
Petroleum & Chemical Storage
Fleet Fueling
LPG Storage
Design-Build & Project Management
Projects
Company
About Us
Bid Packages
Shared Files
Survey Forms
Contact
Phone / Email
Careers
Survey Forms
Water Service Line Survey
Full Name
Please enter your full name.
First
Last
Phone
Please enter a valid phone number where we can reach you.
Email
(Required)
Please List your Email Address
Address
(Required)
Please provide the house number and street for this residence.
Street Address
City
ZIP / Postal Code
Residence Type
(Required)
Select the type of residence this address represents.
Single Family Residence
Multi-Family Residence
Building/Other
School
Childcare Facility
Contains Lead Solder
(Required)
Indicate if the plumbing in this residence contains lead solder.
Yes
No
Not Sure
Point-of-Entry Treatment System
(Required)
Select if there is a Point-of-Entry (POE) treatment system installed.
Point-of-Entry (POE) treatment is any unit installed to treat the water entering a house or building. Most often a filtration system installed close to the where the service enters the building. Filters installed underneath sinks or on taps are NOT considered POE treatment.
Yes
No
Not Sure
Service Line Details - Customer Owned
Material (Customer)
(Required)
Select the material of the service line owned by the customer.
Lead
Galvanized Steel
Plastic
Copper
Not Sure
Other (Please Describe)
Material (Customer Described)
(Required)
Pipe Size (Customer)
(Required)
Select the size of the customer-owned service line.
1/2"
3/4"
1"
Not Sure
Other (Please Describe)
Pipe Size (Customer)
(Required)
Lead (Customer)
(Required)
Select if this service line owned buy the customer previously contained lead.
Yes
No
Not Sure
Exact Install Date (Customer)
Enter the exact installation date if known.
MM slash DD slash YYYY
Approximate Install Date (Customer)
Enter an approximate installation date if the exact date is unknown.
MM slash DD slash YYYY
System Owned Details
System-Owned Portion
(Required)
Do you have knowledge of your system from the curb stop to water main?
Select One
Yes
No
Service Line Details - System Owned
This section is ONLY if you have knowledge of the system from the Curb stop to water main.
Material (System)
Select the material of the service line owned by the customer.
Lead
Galvanized Steel
Plastic
Copper
Not Sure
Other (Please Describe)
Material (System)
Pipe Size (System)
Select the size of the customer-owned service line.
1/2"
3/4"
1"
Not Sure
Other (Please Describe)
Pipe Size (System)
Lead (System)
Select if this service line owned buy the customer previously contained lead.
Yes
No
Not Sure
Exact Install Date (Customer)
Enter the exact installation date if known.
MM slash DD slash YYYY
Approximate Install Date (Customer)
Enter an approximate installation date if the exact date is unknown.
MM slash DD slash YYYY
Additional Info
System Photos
If photos are provided they may assist in identifying/validating the pipe material, however photos are not required.
Drop files here or
Select files
Max. file size: 50 MB, Max. files: 5.
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