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2. Contact Information
4. Name*
5. Email Address*
7. Phone Number*
11. Service Location Information
13. Address of service line*
14. Town
15. State
17. Did you receive a letter from Groton Utilities regarding your service line pipe?*

    1. Yes
    2. No
18. Are you the property owner or tenant?*

    1. Property Owner
    2. Tenant/Renter
22. If you answered YES, what type of letter did you receive?

    1. GRR
    2. Lead
    3. Unknown
24. If no letter was received you can research your service line material type using the Customer Self Indentification Instructions link found on the main Lead Service Line Inventory page.
26. What would you like to do next?*

    1. Schedule replacement of GRR or LEAD service line
    2. Schedule an inspection of your UNKNOWN service line
    3. Self-Indentify my UNKNOWN service line type
    4. Talk to a team expert at Groton Utilities
    5. Other
27. If OTHER, please explain what you would like to do next.
29. Please use the space below for any questions you may have:
Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

* indicates a required field