Lead Service Line Inventory (LSLI) Customer Survey Southwest Water Authority Question Title * 1. What is your first name? Question Title * 2. What is your last name? Question Title * 3. What is your account number? (Can find on bill) Question Title * 4. What is your phone number? Question Title * 5. What is your email address? Question Title * 6. What is your 911 property address? (Location of the account/service) Question Title * 7. Building Type/Use Single Family Multi Family School Commercial Child Care Child Care Licensed (in home) Commercial Public/Government Owner Question Title * 8. Type of Occupancy Owner Renter/Tenant Question Title * 9. Type of Service Usage Domestic Drinking Water Agricultural/Pasture Tap Other Question Title * 10. Number of Homes Connected to a Single Service Question Title * 11. Service Line Material (Materials used from the SWPP Meter Pit or Curb Stop, to the first shut off valve inside the building, or point of use.) The image above represents a simple configuration of a water service line. SWA is interested in the portion labeled 'Customer Owned Service Line' for our purposes. Below are four images of service line materials you may encounter, along with methods that will help you confirm the material. Lead Copper Galvanized Steel PVC/Plastic HDPE (Black Poly) PEX Asbestos-Cement Other Non-Lead Unknown Not Yet Installed Question Title * 12. Pipe Identification Methods Question Title * 13. How did you verify your service line type? Visual Inspection Plumbing Records Scratch Test (see pipe identification methods above) Other (please specify) Question Title * 14. Service Line Installation Date Date: Not Yet Installed (mark with x) Unknown (mark with x) If unknown, provide the year the home/building was built Question Title * 15. Add a photo of the water service line entering inside the building, if possible PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only. Choose File Choose File No file chosen Remove File Add a photo of the water service line entering inside the building, if possible Question Title * 16. Building Plumbing Material Installation Date Before 1989 Between 1989 and 2014 After 2014 Unknown Question Title * 17. Building Primary Plumbing Material 1: (Most common plumbing material used) Copper with Solder Galvanized Steel PVC PEX Other Non-Lead Unknown Question Title * 18. Building Primary Plumbing Material 2: (Second most common plumbing material, if any) Copper with Solder Galvanized Steel PVC PEX Other Non-Lead Unknown Question Title * 19. Point of Use Treatment Devices (such as a filter on faucet, RO system under sink, Carbon canister on faucet) Yes No Question Title * 20. Point of Entry Treatment Devices (such as Whole House Filter/Treatment, Water Softener or RO Unit) Yes No Done