T-Meter Extension Request Webform
Temporary Hydrant Meter: Request to Extend Usage Period

Webform February 8, 2023

This form is intended to be used to obtain general information.

Information about how EMWD will use your information can be found within EMWD's Privacy Policy.

This form is to request contact regarding the Temporary Construction Meter (fire hydrant) on property as it has exceeded the permitted 12-month use. The completed form will be submitted to the Development Services Department and staff will contact you soon.

IMPORTANT! EMWD’s Administrative Code 5.204 sections (a) and (b), restricts this type of service to only a 12-month use. Therefore, we are required to disconnect/remove the temporary meter within 30 days from the date of notice the T-Meter has exceeded the permitted 12-month use.

I am requesting an extension on my T-Meter for the following reason(s):

Please explain in detail the reason this project was not completed during the previous time frame requested (12 month permit issuance period): *

Existing Meter Size:

5/8"

2 1/2"

Application Billing Information:

Company Name: *

Tax ID: *

EMWD Billing Account Number: *

Meter Number: *

Billing Address: *

Billing Contact Name:

Billing Contact Phone:

Billing Contact Email:

Project Information/Site Contact:

Project being served (TM, PM, APN): *

Is use of T-Meter supplying same project:

Yes

Company Name : *

Name of company utilizing T-Meter

Field Contact Name: *

Field Contact Phone: *

Field Contact Email:

Days & Hours of Site Operation:

Projected Expected End Date:

Current Use

Use Options:

Seasonal/Single Lot Residential Construction (TS) (5/8” or 1” only)

Dust Control/Compaction/Street Sweeping/Paving (TM)

Pre-watering/Grading (BE)

Licensed Potable Water Hauler (TL)

FDA Permit Number:

FDA Permit Number Expiration Date:

Use Option:

Construction of Recycled Irrigation system (TT)

On Site Pipe Size:

Use Option :

Other (Please Specify)

Other (Please specify):

EMWD Contact:

Name of EMWD Inspector

WO#:

EMWD Work Order #

CO#:

EMWD CO#

Spec#:

EMWD Spec#

Date: *

Electronic Signature: *

By checking this box, I certify that I have completed this form and affirm that I am the above account holder and the information contained herein, including any and all additional documentation submitted via email, fax or mail, is complete and accurate.

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T-Meter Extension Request Webform
Temporary Hydrant Meter: Request to Extend Usage Period

I am requesting an extension on my T-Meter for the following reason(s):

Application Billing Information:

Project Information/Site Contact:

Current Use

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T-Meter Extension Request Webform Temporary Hydrant Meter: Request to Extend Usage Period

I am requesting an extension on my T-Meter for the following reason(s):

Application Billing Information:

Project Information/Site Contact:

Current Use

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T-Meter Extension Request Webform
Temporary Hydrant Meter: Request to Extend Usage Period