City of Santa Barbara

WebHelp@SantaBarbaraCA.gov

735 Anacapa Street, Santa Barbara, CA, 93101, US

805-963-0611

Lead And Copper Sampling Program Questionnaire

Please complete the information below to the best of your ability.

Phone Number

1. When was your home built?

2. Is your home plumbed with copper pipe?

Yes

When was the copper pipe installed?

3. Does your home plumbing include a water softener?

Yes

If yes, please check one:

Hot water only

Cold water only

Both hot and cold

4. Do you have any other type of drinking water treatment device? (Activated carbon filters, reversed osmosis, etc.)

Yes

If yes, please describe (what/where):

5. Do you have any plans for in-house plumbing modifications within the next six (6) months?

Yes

If yes, please describe:

Are you willing to participate in this free program? (Occurring June - Sept 2023)

Yes