Customer Submission Request - Cooper & Lead

On December 16, 2021, the U.S. Environmental Protection Agency (EPA) announced the Lead and Copper Rule Revisions (LCRR) Revised Lead and Copper Rule | US EPA, would go into effect to support development of actions to reduce lead in drinking water.  The intent of the LCRR is to identify all lead in service lines/pipes in communities across the nation. The LCRR compliance date is Oct 16, 2024.

EPA has directed states and public water systems to prioritize developing lead service line inventories (LSLI). Each public water system must submit their LSLI to DEQ by October 16, 2024. 

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ACCOUNT #  *
NAME  *
ADDRESS - CITY - STATE - ZIP *
PHONE # *
Is your meter attached to any dwelling?  YES OR NO

If NO, this form is completed and needs to be returned to our office. If YES, continue to the next question. 

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Is anyone living at this location? YES OR NO 
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What year was your service line installed? 
What material is your service?  Check One of the following:
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This form is now complete and needs to be returned to our office. 
Thank you for taking the time to help us meet the new DEQ Lead and Copper Rules Requirements.

We appreciate you!

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