Form Center

Search Forms:

Search Forms Select a Category

All Categories
Admin Forms
Contact the Advanced Water Purification Demonstration Facility

Customer Service Forms
Email Sign-up

Engineering
Report Water Waste

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Application For Recycled Water Service

Sign in to Save Progress

This form has been modified since it was saved. Please review all fields before submitting.

Customer:
Name*
Relationship to Property*
Address*
Phone*
Contact Person
Designated Recycled Water Supervisor
If different than Property Owner - Please provide a notarized document showing Owners' consent.
Property Owner:
Name
Phone
Address
Contact Person
Property Description:
Tax Assessor's Parcel Number(s)
Lot Size
Project Description
Meter Location
Water Use:
Service Type:*
1. Construction
1. Irrigation
1. Other
Expected Start Date*
Estimated duration of use*
To*
AM/PM
From*
AM/PM
Days of Week*
1. Sun
2. Mon
3. Tue
4. Wed
1. Thu
2. Fri
3. Sat
Check all that apply
Gallons Per Day*
or Total Gallons Projected
Peak Gallons Per Minute
Total Area Served (sq. ft.)
Total Area Served (acres)
Turf
Square Feet
Drought Tolerant
Square Feet
Specific Description of Use
Applicant Signature
Date