Start Service Request

Move or Transfer Service requests should be requested at least two (2) business days before you will need the water on.
Please complete this form ONLY if you are the property owner.
Tenants should have their landlord contact us.

"*" indicates required fields

Select Form Language

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Form Language

English

Spanish

Service Location Details

Start Service Date*

Company*

Service Address*

Street Address Address Line 2 City State ZIP Code

Assessor's Parcel Number (APN)*

This Location was part of The California Camp Fire (2018)*

Primary Account Holder

Full Name*

Primary Account Holder*

First Middle Last

Last 4 SSN*

Date of Birth*

Last 4 SSN*

Date of Birth*

Additional Account Holder

Secondary Account Holder*

Additional Authorized User*

Full Name*

Full Name Spouse*

First Middle Last

Date of Birth*

Secondary Account Holder Date of Birth*

How Can We Reach You?

Mailing Address*

Same as Service Address

Street Address Address Line 2 City State ZIP Code

Email Address*

Enter Email Confirm Email

Phone Number*

Preferred Method of Contact*

Submit Form

Consent*

Detalles de la ubicación del servicio

Fecha De Inicio Del Servicio*

Start Service Date (ESP)*

Compañía*

Company (ESP)*

Dirección de servicio*

Service Address (ESP)*

Dirección de Envío Dirección de Envío dos Ciudad Estado Código Postal

número de parcela de los evaluadores (APN)*

Assessor's Parcel Number (APN) (ESP)*

Titular principal de la cuenta

Nombre completo*

Primary Account Holder (ESP)*

Primero Medio Último

Últimos 4 SSN*

Fecha de nacimiento*

Last 4 SSN (ESP)*

Date of Birth (ESP)*

Titular de cuenta adicional

Additional Authorized User (ESP)*

Titular de cuenta secundario*

Nombre completo*

Full Name Spouse (ESP)*

Primero Medio Último

Fecha de nacimiento*

Date of Birth Spouse (ESP)*

¿Cómo podemos comunicarnos con usted?

Dirección postal*

Mailing Address (ESP)*

Igual que la dirección de servicio

Dirección de Envío Dirección de Envío dos Ciudad Estado Código Postal

Dirección de correo electrónico*

Email Address (ESP)*

Enter Email Confirm Email

Número de teléfono*

Phone Number*

Método preferido de contacto*

Preferred Method of Contact (ESP)*

Enviar formulario

Consentimiento*

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SUBMISSION DATE

Our offices will be closed Monday November 11th, in observance of Veteran’s Day. If you have any urgent issues, you can still call into your district for assistance.

Select Form Language

Service Location Details

Primary Account Holder

Additional Account Holder

How Can We Reach You?

Submit Form

Detalles de la ubicación del servicio

Titular principal de la cuenta

Titular de cuenta adicional

¿Cómo podemos comunicarnos con usted?

Enviar formulario

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