Water Quality Questionnaire

This questionnaire is for current utility customers only.

Tell Us When the Water Quality Incident Occurred

Please use this form to tell us about a water quality concern you experienced within the past 2 days.

Water Quality Observation Date*

Please select the date (within the past 2 days) when the water quality concern occurred.

Water Quality Observation Time of Day*

Please select the time of day when the water quality concern occurred.

Please Provide Us With Your Contact Information

Your Phone Number*

Phone

Your Service Address*

Service Address Unit

Please enter a unit #, such as apartment #, suite, etc.

Your Service City*

Select

Your Service - State*

Your Service Zip Code*

Please Tell Us About The Location Where This Water Quality Concern Occurred.

Please provide us with your business, retail, school, or institutional name.

When did you last change the hot water tank anode?*

Each water heater is equipped with a magnesium anode rod in order to temporarily limit corrosion within the tank.

What kind of pipes do you have at your facility?*

Copper

Plastic

Galvanized

Don't know

Do you use a whole house water filtration system?*

Yes

Tell Us More About The Water Quality You Observed

What was the appearance of the water?*

The Water Was Clear

The Water Had A Color

Did the water contain any particles?*

Yes

Did the water have a certain taste?*

Yes

You selected "Other" - Please describe the taste in the box below.

Did the water have an odor?*

Yes

You selected "Other" - Please describe the odor in the box below.*

If you can, please attach a picture of the water to help us see what you're seeing.

Drag and drop files here or

General Water Quality Observations

Have you experienced this same water quality issue in the past?*

Yes

When did you experience this same issue?*

Please select all that apply.

3-6 months

6-12 months

1-3 years

Greater than 3 years

If a similar issue was experienced, did you report it to SGWASA?*

Yes

If a similar issue was reported previously, did SGWASA test the water?*

Yes

Did any of these items occur in your area within the past 48 hours that may have contributed to the water quality?*

Please select all that apply.

Water Main Break.

Hydrant Flushing.

Water Main Pipe Construction.

Water Tower Construction.

Fire Department Responded to a nearby fire.

Someone hooked into a fire hydrant to power wash a building.

Someone hooked into a fire hydrant to fill a pool.

None that I can think of.

Water Quality Customer Notes

Please add any additional comments that you would like us to know about this water quality concern.

What Action Would You Like SGWASA To Take?*

No further action, I just wanted SGWASA to know about my water quality.

Please consider flushing the water system near my address.

I would like SGWASA to flush the area near my address and then contact me to discuss my in-home water quality concerns.

Send me a copy of my responses

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Tell Us When the Water Quality Incident Occurred

Please Provide Us With Your Contact Information

Please Tell Us About The Location Where This Water Quality Concern Occurred.

Tell Us More About The Water Quality You Observed

General Water Quality Observations

Next Steps