Your contact information:

Name
E-mail
Phone

Block Number:

Lot Number:

Meter Reading:                                    Meter Read on Date (mm/dd/yy):

How would you describe your outdoor water use during the reporting period?

1. None
2. Occasional cleaning uses and/or hand-watering of plants & shrubs
3. Hand-watering of lawn*
4. Regular watering of lawn with underground sprinkler system*    

*For choices 3 and 4 above, please estimate your total watered lawn area:

square feet