NOTICE OF PRIVATE UNDERGROUND FACILITIES
CEMENT HILL WATER MAIN PROJECT
(Please complete and return this form, if you have private underground facilities that may be affected by new water mains)
Your Name and Mailing Address:
Name:
Address:
City:
State:
Zip:
Phone:
Email:
Your Property Address (If Different):
Name:
Address:
City:
State:
Zip:
Phone:
Email:
The best way to contact you during business hours is:
Phone / Cell Phone:
E-Mail:
Fax:
I utilize the following underground improvements that are under the roadway along my property:
Private Waterline
Electrical or Telephone Service
Drainage Pipe
Other (Please Describe):
I can meet with an engineer or technician (with prior appointment) to show them the location:
During Business Hours.
Weekdays After p.m.
Please click the submit button once to send your completed form.
Alternatively, you can print the completed form and mail to:
Mr. John Houlihan, HydroSceince, Inc.
10569 Old Placerville Road
Sacramento, CA 95827-2504
FAX: (916) 364-1491