Translations:

Water Service Line Replacement Permission Form

The Philadelphia Water Department (PWD) is working to replace water service lines containing lead or galvanized metal throughout the City of Philadelphia.

PWD will be using contracted plumbers for replacement of service lines.

Because residential service lines are owned by the property owner, PWD must get property owners to sign this form to give PWD permission to replace their service line. Completing this permission form is the first step in the service line replacement process. See more below the form for information about what to expect during service line replacement.

Property InformationInformación de la Propiedad부동산 정보

By signing this form, I certify that I am the owner of this property and grant PWD and their contractors permission to enter this property to perform any digging, testing, and/or repairs determined necessary to replace my water service line. I agree to make the necessary plumbing accessible for workers to complete the water service line replacement. I understand that if PWD determines these conditions are not met, the replacement will not occur.

Al firmar esta forma, certifico que soy el propietario de esta propiedad y otorgo a PWD y a sus contratistas permiso para ingresar a la misma a fin de realizar cualquier excavación, prueba y/o reparación que se determine necesaria para reemplazar mi línea de servicio de agua. Acepto hacer accesible la plomería necesaria para que los trabajadores puedan completar el reemplazo de la línea de servicio de agua. Entiendo que, si PWD determina que no se cumplen estas condiciones, el reemplazo no se llevará a cabo.

본 양식에 서명함으로써, 저는 본 부동산의 소유자임을 증명하며, 저의 급수관 교체를 위해 필요하다고 판단되는 굴착, 검사 및/또는 수리 작업을 수행할 목적으로 PWD 및 그 계약업체가 본 부동산에 출입하는 것을 허가합니다. 또한 저는 작업자들이 급수관 교체 작업을 완료할 수 있도록 필요한 배관 설비에 대한 접근을 가능하게 하는 데 동의합니다. 만약 PWD가 이러한 조건들이 충족되지 않았다고 판단할 경우, 급수관 교체 작업이 진행되지 않음을 인지하고 있습니다.

Use your mouse or touch screen to draw your signature in the box below.Utilice el ratón o la pantalla táctil para dibujar su firma en el recuadro de abajo.

Contact Information

Please provide the contact information where you can be reached during normal business hours, and the contact information for an authorized representative or tenant to provide access, if different from yourself:

Información de contacto

Por favor, proporcione la información de contacto donde se le pueda localizar durante horario comercial habitual, así como la información de contacto de un representante autorizado o inquilino que pueda facilitar el acceso, en caso de ser una persona distinta a usted:

Contact information

정규 업무 시간 중 연락 가능한 연락처를 기재해 주십시오. 또한, 귀하 본인이 아닌 다른 분이 출입을 허용할 경우, 해당 권한 대리인 또는 세입자의 연락처도 함께 기재해 주시기 바랍니다.

What to expect

Before replacement

  • PWD and/or its approved contractor(s) will contact you to schedule an appointment to discuss the areas of the property that may be disturbed by construction and post-construction restoration protocol.
  • Post-construction restoration requirements will also be discussed. Significant restoration not covered by PWD will be the responsibility of the property owner. This may include items such as steps, patios, retaining walls, specialty or tinted concrete, stone or brick walls or paving, structures of any type, trees, shrubs, bushes, and flowers.
  • After the assessment, PWD or the property owner can elect to not complete the service line replacement.
  • The property owner must provide reasonable, safe, lighted, and unblocked access to the water meter and to the water service piping inside the property. This includes access to the wall or floor area where the water line enters the building and moving any items blocking access such as boxes, furniture, washers, dryers, etc. If the water meter and/or service line is located behind a finished wall or under a finished floor, the property owner is responsible for removing the obstruction and establishing the necessary access to perform the work. The property owner is responsible for repairs of the disturbed area after service line replacement.
  • PWD will provide the resident with instructions for the required post-replacement flushing of the property’s plumbing system and a pitcher filter with instructions for use.
  • PWD and/or its approved contractor(s) will take interior and exterior photos before the work begins.
  • PWD and/or its approved contractor(s) will contact you to schedule the water service line replacement.

During replacement

  • The property owner or representative who is at least 18 years old must be at the property on the date and time scheduled for PWD to perform the work.
  • A PWD approved contractor(s) will turn off the water service to the building for about 4 hours while completing replacement.
  • A PWD approved contractor(s) will replace all portions of the service line identified as either lead or galvanized requiring replacement at no cost to the property owner.
  • PWD will employ all reasonable methods and precautions in performing the service line replacement to avoid or minimize disturbance to the interior and exterior of the property.

After replacement

  • PWD and/or its approved contractor(s) will restore disturbed areas by backfilling with the appropriate material and restoring disturbed areas.
  • The property owner may be responsible for the restoration of exterior landscaping, hardscaping, or structures on the property that impede the replacement of the water service or are disturbed as part of the service line replacement.
  • PWD will take interior and exterior photos after work is complete.
  • The property owner or resident representative is responsible for performing the required flushing of the property’s plumbing system, as described in PWD’s instructions. The property owner or resident representative is also responsible for using the pitcher filter and cartridges, as described in PWD’s instructions.
  • After installation, maintenance of the water service line from the water main to the water meter remains the responsibility of the property owner. All work associated with the service line replacement will be guaranteed for a one-year period following completion of the work.
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