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Water Use Restrictions Report
Name
field type single line
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Email
field type email
Mobile Phone Number
field type single line
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Home, Business or Builder?
*
field type drop-down
Home
Business
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Report Date
*
field type date
Report Time
*
field type time
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Address:
*
field type single line
Enter the address the address or location you are reporting.
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Comments
field type multi line
Provide a description of the water use restrictions not followed.
Attachments
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