Download the PDF HERE: Lead and Copper Inventory Survey

If you need any help completing the survey, please call: 740-439-1269
You can return this completed form in multiple ways:
Fax: 740-439-5775
Mail or Drop off: 11272 East Pike Rd. Cambridge, OH 43725
Complete the form below and click ‘Submit’.

GCWD - Lead and Copper Inventory Survey
Does the service connection supply multiple locations?
Examples: 3 Apartments, 2 houses, a house and a garage/barn, etc.
Where does the water line go?
Type of service line material from (PW) meter pit or curb box valve to the above. This is usually located in the basement before the isolation of the valve. Check all that apply:
Service Type
Interior Plumbing type. Check all that apply: