Recycled Water Service Application

Please be sure to complete the rebate application at the end of any project.

If submitting plans please include the following items on all plans:

Potable/recycled water mainline and valve locations
All potable and recycled water lines
Specific recycled water use areas
Specific potable water use areas
Location and size of all service connections and meters, including fire protection
Equipment legends
Sewer facilities
Locations and descriptions of all backflow prevention devices
Buildings
Location of all drinking fountains
Ball fields and courts
Play areas and equipment
Water features
Location of all wells
Location of all streams and water bodies
Site location map, vicinity map
Recycled Water Criteria Block
District Recycled Water Signature Block
MNWD Standard Notes
MNWD Standard Detail Drawings

Owner / Customer Name

Title

Phone Number

Owner/Customer Email

Property Management Company

(if different than owner)

Management Company Name

Property Manager Contact Number

Property Manager Email

Project Use Site Info

Project Address or Location

Nearest Arterial Streets

Account Number(s)

Landscape Maintenance Company Name

Title

Landscape Maintenance Company Email

This Will Be A

New Recycled Water System (New Construction)

Recycled Water Conversion (New Potable Irrigation Installed Per Recycled Water Standards)

Recycled Water Retrofit (Existing Potable Irrigation Retrofitted for Use of Recycled Water)

Type of Recycled Water Use

Explain Other/Special Conditions

Upload Drawing(s)

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I, the applicant, have read and understand the MNWD Rules and Regulations for Recycled Water and agree to restrict recycled water use for the purposes described in this application. https://www.mnwd.com/app/uploads/2017/03/Rules-and-Regulations-Rev-3-2017.pdf

I agree to use recycled water in accordance with the Regulations and all other applicable documents. I understand that recycled water may not be compatible with certain types of vegetation because of its composition. I agree that MNWD and SOCWA will not be liable for damages that may occur to vegetation or for damages that may occur due to uses of recycled water.

I hereby acknowledge and consent to MNWD’s use at its option of recycled water in lieu of potable water for the purposes herein mentioned in accordance with the Regulations of MNWD and SOCWA and as may be required by Chapter 894 of the Statutes of 1978, the Water Code of the State of California and Section 2 of Article X of the California Constitution.

Applicant acknowledges and agrees to the terms and conditions set forth in the Program Rules and related documents.

I Agree

Date

Applicant's Title

Applicant's Signature

First Name

Last Name

Choose how to sign

Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.