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2. What is this survey about?

   City of Billings Public Works is working to ensure that all of the materials in the water system are known, inventoried, and up to modern standards. As there's no lead in the water delivered to your home, particles of lead can get into your drinking water as it passes through Lead Service Lines. 

   The City provides service line material inspections for FREE. A representative will be scheduled to visit your home and inspect the service line where it enters your house near the water meter. 

   For the health and safety of you and loved ones, please fill out this survey and request a FREE inspection as needed. Thank you!

   
   

4. First Name*
5. Last Name*
7. Street Address*
8. Phone Number*
10. Email Address
12. Request Assistance

    1. I would like to schedule an appointment to have my service line material inspected.
14. Service Line Material Information

    Service line material can be identified by the following characteristics:

    • Lead Pipe will reveal silver metallic color when scraped and will not attract a magnet
    • Copper Pipe will reveal metallic "new penny" color when scraped and will not attract a magnet
    • Galvanized Pipe will reveal silver or grey metallic color when scraped and will attract a magnet
    • Plastic Pipe comes in many colors and will not appear metallic when scraped or attract a magnet

    I have surveyed my service line materials and have identified the material as:

    1. Lead

    1. Copper

    1. Galvanized Steel

    1. Plastic
16. Comments
18. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
20. Electronic Signature
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23. 1. Receive an email copy of this form.
24. Email address

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25. Submit

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