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Cross-Connection Control Self-Assessment
Residential Water Usage

If you are the tenant, please forward this on to the property owner for completion.

If you are a residential customer and we do not receive your completed self-assessment by the date listed above, the District reserves the right to discontinue service to the premises. 

ML# can be found on the Self-Assessment form

Please indicate if your Residence has any of the fallowing (check All that Apply):

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