Show/Hide

EID RESPONSE TO COVID-19 

Protecting Public Health and Safety

 

Recycled Water Program Inspection Request Form

Print
Press Enter to show all options, press Tab go to next option
Please correct the field(s) marked in red below:

EID Recycled Water Program inspection requests will be completed within two business days after the request date.

Please note:  The day of the request is not recognized as the first business day. 

Fields marked with *  are required to be completed to process the request.

Select the type of inspection below:

 *
Other - please provide details if "Other" was selected in the drop down menu above:
Contact First Name:
 *
Contact Last Name:
 *
Company/Business Name:
Contact Phone Number:
 *
Please add the address locations and lot number for each location.
Inspection Addresses: Lot Number (if known)
Location 1
Location 2
Location 3
Location 4
Location 5
Contact Email:
 *
Additional Information:
  1. To receive a copy of your submission, please fill out your email address below and submit.
    CAPTCHA
    Change the CAPTCHA codeSpeak the CAPTCHA code