VA WARN Cloth Mask Request
FEMA has provided washable, reusable free cloth face masks to Water & Wastewater purveyors in Virginia. Although these masks are provided by FEMA without cost, special arrangements for mailing or shipping is being provided by VA WARN. USEPA and AWWA National were instrumental in obtaining the masks through FEMA.  

The masks are allocated at a rate of 5 face masks per employee.  To request masks for your utility, please complete the following request form.   Masks will be shipped on a first-come, first-serve basis.
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Requesting Utility/Company *
Shipping Address (please include street address, city, state, and zip code) *
Utility Contact Name *
Email Address *
Number of Employees *
Permit Number (SDWIS, NPDES, or VPDES) *
Population Served *
Utility Type
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