Untitled Question Title * 1. Please provide your contact information Name Company Address Address 2 City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code Email Address Phone Number Question Title * 2. Was your house built prior to 1987? Yes No Question Title * 3. Was your household water connected to the Blacksburg Water System prior to 1987? Yes No Question Title * 4. What type of material is used for your outside water service line from your water meter to the point of entry into your home? Lead Pipe Copper Pipe with Lead Solder Plastic or PVC or Pex Galvanized Iron Cast Iron Steal I am not sure Question Title * 5. What color is your outside water service line from your water meter to the point of entry into your home? (scratch test - you can use a key or coin to scratch you service line where it enters your home and to determine the color) Gold Copper Silver White or Blue Plastic Other Other (please specify) Question Title * 6. What type of pipe is your house plumbed with? Lead Pipe Copper Pipe with Lead Solder Plastic or PVC or PEX Galvanized Iron Cast Iron Steel I'm not sure Done