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2. Are you a Monte Vista Water District customer?*

   1. Yes
   2. No
4. Do you have a working sprinkler system?*

   1. Yes
   2. No
   3. I do not know
6. Do you have a working sprinkler timer?*

   1. Yes
   2. No
   3. I do not know
8. If yes, how many sprinkler timers do you have?

   1. 1
   2. 2
   3. 3 or more
10. Using the list below, please check the item that best describes your concerns.*

    1. My sprinklers are spraying the sidewalk or other non plant surfaces
    2. My sprinkler timer is at least 10 years old
    3. My sprinkler timer is not working
    4. I need guidance on how long to water my yard
    5. I have a few broken sprinklers
    6. I have a broken sprinkler valve
    7. The water pressure inside my home is very high
    8. I may have a leak outdoors and I am not sure what to do
    9. I need general advice on how to save water in my home
    10. Other
12. If you need general advice on how to save water for your home, please select the program(s) you are interested in:

    1. Sprinkler Check-up (provides an in-person evaluation and customized watering schedules, recommended repairs, etc.)
    2. Water Efficiency Survey (provides a virtual evaluation and basic recommendations for indoor and outdoor water use)
    3. Receive a free Conservation Kit
    4. Learn more about rebates (i.e., turf removal, toilets, clothes washers, nozzles, irrigation controllers)
14. Do you have leaks inside your home?
    -- Select One --YesNoI don't know
16. If yes, please check the item that best describes your concerns (please note: we do not service repairs occurring inside walls or underground).

    1. Angle Stop
    2. Hose Bib
    3. Kitchen Faucet
    4. Bathroom Faucet
    5. Showerhead
    6. Toilet
    7. Other
18. First Name*
19. Last Name*
21. Address*
23. City*
24. State
25. Zip Code
27. Phone Number*
28. Email*
30. MVWD Account Number
32. Please pick the one that best describes you.

    1. Homeowner
    2. Renter
    3. Other
33. e-Waterline Newsletter

    1. I would like to receive this quarterly newsletter via email.
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field