Water Service Line Survey Form

Please answer all questions to the best of your ability.

Read more about the Water Service Line Inventory and find resource images at this link (opens in new window).

Date
Type of Water Pipe (Check one)
To help identify the pipe material, scratch the service line with a coin in the scratch area shown on the image to the right. What color is the area you scratched? (Find a diagram of the pipe and area to scratch at https://pendleton.or.us/publicworks/page/water-quality-lead-service-line-inventory)
Type of Internal Plumbing
Please see information page about how to determine line/pipe material.
If you have a copper service line(s), is lead solder used at any connection points?
If known, has the plumbing been replaced or renovated in your home?
Would you be willing to collect water samples for the Water Department if your property meets the criteria?
The City of Pendleton Samples water from around town for lead and copper.
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