This free survey is powered by
  1. Surveys
  2. 2013
  3. June
  4. L
  5. Long Creek Township Water Department Residential C
0%
Questions marked with an * are required Exit Survey
 
 
* Customer Name
   
 
 
 
* Name of Person Completing Survey
   
 
 
 
* Phone Number
   
 
 
 
* Customer Address
   
 
 
Inside Residential Plumbing Fixtures, Machines, and Devices
Yes No Not Sure
* Kitchen Sink Faucet Sprayer
* Ice Maker
* Electric Dish Washer
* Water Purifier
* Water Softener
* Deep Utility Sink
* Boiler Heat
* Whirlpool/Hot Tub
* Bidet
* Toilet
* Shower Sprayer with Hose
 
 
 
Other Inside Residential Plumbing Fixtures, Machines, and Devices
   
 
 
Outside Residential Plumbing Fixtures, Machines, and Devices
Yes No Not Sure
* Outside Faucets
* Lawn Irrigation System
* Portable High Pressure Washer
* Swimming Pool
* Garden Hose Chemical Sprayer
* Pond
* Whirlpool/Hot Tub
* Private Well/Cistern
* Yard Hydrant
 
 
 
Other Outside Residential Plumbing Fixtures, Machines, and Devices
   
 
 
 
Comments/Suggestions: