Forms

1 – Application for Water Service

Form No. 1 2.26.24 (PDF 2 MB)

2 – Customer’s Guarantee Receipt

Form No. 2 2.26.24 (PDF 828 KB)

3 – Bill for Service

Form No. 3 LA (PDF 480 MB)

4 – Main Extension Contract

Individuals
911-W (PDF 81 KB)

5A – Main Extension Contract

Subdivisions, tracts, housing projects, industrial developments, commercial buildings, or shopping centers Distribution Plant Only – No Special Facilities Fire Flow Requirements Meet General Order No. 103
912-W (PDF 151 KB)

5B – Main Extension Contract

Subdivisions, tracts, housing projects, industrial developments, commercial buildings, or shopping centers Distribution Plant Only – No Special Facilities Fire Flow Requirements Exceed General Order No. 103
913-W (PDF 162 KB)

5C – Main Extension Contract

Subdivision, tracts, housing projects, industrial developments, commercial buildings, or shopping centers Special Facilities and Distribution Plant Fire Flow Requirements Meet General Order No. 103
914-W (PDF 195 KB)

5dD – Main Extension Contract

Subdivision, tracts, housing projects, industrial developments, commercial buildings, or shopping centers Special Facilities and Distribution Plant Fire Flow Requirements Exceed General Order No. 103
915-W (PDF 203 KB)

5E – Main Extension Contract

Subdivision, tracts, housing projects, industrial developments, commercial buildings, or shopping centers Distribution Plant – Special Facilities (together or separately) – Fire Flow Requirements Either Meet or Exceed General Order No. 103
916-W (PDF 147 KB)

5F – Main Extension Contract

Special facilities Subdivisions, Tracts, Housing Projects, Industrial Developments, Commercial Buildings, or Shopping Centers
917-W (PDF 106 KB)

6 – Notice of Returned Item

Form No. 6 2.26.24 (PDF 860 KB)

6A – Customer Remittance Return

Form No. 6a 2.26.24 (PDF 693 KB)

7 – Reminder Notice

Form No. 7 (PDF 483 MB)

7A – Urgent Notice

Form No. 7A (PDF 2 MB)

8 – Important Notice

Post-Disconnection to title
Form No. 8 2.26.24 (PDF 726 KB)

9 – Application for Private Fire Service

For use when no service installation is required
Form No. 9 (PDF 99 KB)

9A – Application for Private Fire Service

For use when a service installation is required (Cost to be paid by Contractor)
1091-W (PDF 110 KB)

9B – Application for Private Fire Service

For use when a service installation is required (Cost to be paid by Contractor)
1092-W (PDF 105 KB)

9C – Contractor’s Agreement for Installation of Private Fire Service

1093-W (PDF 99 KB)

10 – Water Service for House Construction

Form No. 10 (PDF 90 KB)

12 – Uniform Fire Hydrant Service Agreement

Form No. 12 (PDF 158 KB)

13 – Application to Withdraw Water From Fire Hydrant

Form No. 13 (PDF 87 KB)

14 – Indemnity Agreement for Income Tax Component of Contributions

Form No. 14 (PDF 159 KB)

15 – San Gabriel Valley Water Company AutoPay Application

Form No. 15 2.26.24 (PDF 2 MB)

16A – Los Angeles County Division Notice and Application for California Alternative Rates for Water (CARW)

Form 16A 6-1-23 (PDF 513 KB)

17A – Tenant Notification

2027-W (PDF 38 KB)

18 – Confidentiality and Non-Disclosure Agreement

From No. 18 (PDF 474 KB)

19A – Continuous Service Agreement

From No. 19A (PDF 1 MB)

Comments are closed.

Comments are closed.