Private Service Line Affidavit

The City of Moore is asking you to assist with a materials identification program required by the EPA and ODEQ. We are identifying the type of material of the water service lines that bring water to residences from the water main. Crews will be accessing your private property at the meter box UNLESS you complete the affidavit below. The following criteria must be met in order to submit an affidavit:

You are the legal owner of the property
Your property's water service line has been replaced/installed since 1990
You know the type of material used for your water service line

If all 3 of these criteria are met, and you wish to forgo having crews access and identify your private water service line, please complete the affidavit below. For more information or questions please contact 405-793-5080.

Property Information

Property Address

City

State

Zip

Owner's Name

Owner's Email

I am the legal owner of this property.

Since 1990, the property's private water service line has been replaced/installed.

What was the replacement material?

By signing and submitting this affidavit, you certify that the information provided is true and accurate.

Signature of Property Owner

Sign above.

Date

Private Service Line Affidavit

Affirmation

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