Water Service Line Inventory Survey

Thank you for participating in Burlington 's Water Service Line Inventory Project.

Your assistance with this project is critical and will ensure that we can meet the EPA's deadline for responses. As a small token of our appreciation, there will be monthly gift card raffles beginning in January 2024 for completed survey responses!

Ready to get started? We recommend taking a moment to review our "How To" guide first so there aren't any suprises. Spoiler alert--you will need to snap a photo of your service line as it enters the building as illustrated below.

Please fill out the survey to the best of your ability and we will be in touch if there are any questions after reviewing the results. Thank You!

Primary Contact Name *

Name of the primary contact for this address

Primary Contact Email *

We will only email you if we have questions about your assessment.

Primary Contact Phone Number *

We will only call you if we have questions about your assessment.

Service Location *

Street of address of the property served by this service line

Relationship to property *

Do you own this property? Rent? Manage?

Other: Please specify your relationship to the property

If you've selected "Other: Please Specify", please elaborate here.

How many service lines serve this property? *

If you have more than 2 water service lines please leave a detailed comment at the end of the form.

For what purpose is water service line 1 used?

If you chose "Other" please leave a detailed comment explaining why at the end of the form.

For what purpose is water service line 2 used?

If you chose "Other" please leave a detailed comment explaining why at the end of the form.

Please upload a photo of your water service line that shows where the pipe enters the building *

Press "Choose File" to select your photo file. Once you have chosen a file, press "Upload" to attach it to the form.
Files must be less than 8 MB.
Allowed file types: gif jpg jpeg png bmp pdf.

Please upload a photo of your second water service line that shows where the pipe enters the building

Files must be less than 5 MB.
Allowed file types: gif jpg jpeg png bmp pdf.

Does a heavy duty magnet stick to your water service line? *

Does a heavy duty magnet stick to your second water service line? *

What material is your water service line? *

Please select a material

What material is your second service line?

Material of the property's second service line.

Notes

Add pipe diameter, purpose, or other notes as appropriate.

Water Service Line Inventory Survey

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