Home Government Departments Public Works FAQs / Informational Tools Water Backflow Assembly FAQ water use survey Water Use Survey Which Best describes your facility? Commercial Governmental Medical Multi-Family Industrial Residential Agricultural Do you have an irrigation system? Yes No Do you have a fire protection system? Yes No Do you use water from another source? Yes No Do you have any water equipment? Yes No (Other than standard plumbing fixturess, water softners, etc?)Do you use chemicals? (Other than Yes No standard household cleaners?)Do you have backflow preventers? Yes No Additional Backflow preventers and/or notesName: Position/Title: Company: Address: City, State and Zip: Phone Number: Email: Site Contact: Site Name: Site Address: Site City, State and Zip: