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2. CUSTOMER SERVICE BUSINESS SERVICE APPLICATION
   • Business Hours: Mon-Thurs 7:00 am - 6:00 pm
   • Phone: (855) 654-CVWD
4. General Information
6. Name of Company*
8. Service Address*
10. Property Type:*
    -- Select One --ResidentialCommercial

    If you selected "commercial" as the property type, please answer the following two questions: 

12. Please check the box to activate the following service:*

    1. Domestic
    2. Fire Line
    3. Landscape
14. Business Type/Activity: What type of operations do you perform?*
    -- Select One --OfficeDaycare centerMarket without grinderPublic facility without diningBar/Tavern without foodRetail/ServiceRecreation/Amusement without diningMortuaryHotel with diningMotel with diningBar/Tavern with diningPublic facility with diningRecreation/Amusement with diningHospital - full serviceConvalescent facilityLaundromatCar WashLaundry - commercial/industrialDry CleanerMotel without diningHealth spaChurch/WorshipOutpatient facilityDoctor officeDental officeRestaurant - full serviceRestaurant - fast foodMarket with grinderBakerySchool - Public/Private:  Kindergarten through 12 th gradeSchool - Public/Private: CollegeOther
16. Additional Location Info:
18. Please Identify your legal position to this property.*

    1. Owner
    2. Tenant
    3. Property Manager
    4. Resident
20. Contact Name:*
21. Contact Email:*
22. Phone:*
24. Start Date:*
    Start Date:
25. Tax ID:*
27. Billing Address:*
29. Name of Responsible Party:*
33. Backflow Information
35. Facilities Contact Name: *
36. Phone:*
38. Mailing Address:*
40. Will you manufacture any items at this location?*

    1. Yes
    2. No
42. If you answered yes, please list what you will be manufacturing:
44. Document Upload if Required:

46. The TURN-ON FEE IS $15.00 per account. We also charge at least a $175.00 DEPOSIT PER ACCOUNT. Landscape and Fire Line services are separate accounts. Your request will be completed within 2 Business Days.

    Thank you for contacting Cucamonga Valley Water District.

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48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit

* indicates a required field