By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Lead & Copper Questionnaire

  1. Lead And Copper Participant Survey
  2. Thank you for your interest in participating with lead and copper monitoring. To maintain complete records and estimate your home’s risk factor, we ask that you complete this survey.
  3. First and Last Name
  4. Street Number and Street Name
  5. Street, City, State, Zip
  6. Typically the kitchen sink; if unknown, write "UNKNOWN"
  7. Is A Permanent Water Filter Installed In Your Home?*
    Check one box.
  8. Is A Water Softener Installed In Your Home?*
    Check one box.
  9. What Type of Plumbing Materials Are Used Within The Home?*
    Plumbing Material Can Be Verified By Viewing The Lines Connecting To Your Water Heater And Faucets. Check all that apply.
  10. Thank you for your assistance,
    Alan Cranford Plant Manager, Stones River Water Treatment Plant
  11. Leave This Blank:

  12. This field is not part of the form submission.