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The address you are moving from

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The address you are moving to

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Please upload an image of your Driver's License

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Would you like to sign up for paperless billing? By checking yes, I understand that each month my utility bill will be sent to me by email instead of a paper bill being mailed.

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The Telephone Consumer Protection Act requires that consent must be obtained before contacting a customer on their wireless telephone. As part of our service, calls may be placed to you in connection with this water service agreement with the City of Mansfield. By signing this form, we have your expressed permission to contact you on any wireless number on file with regards to your water service with the City of Mansfield. In addition, you agree that we and/or a third-party debt collector may contact you by telephone or text message at any telephone number associated with your account, including wireless telephone numbers which could result in charges to you, in order to service your account or collect any amount owed to us. You may withdraw the consent to be contacted on your wireless telephone numbers or opt-out any time by written notice, by email, via telephone or by any other reasonable means by contacting the Water Department at the City of Mansfield. If you provide a wireless telephone number on or in connection with this account, you represent and agree you are the wireless subscriber or customary user with respect to the wireless telephone number(s) provided and have the authority to give this consent. Your consent includes contact from companies working on our behalf to service your account.

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Water Customer Service Agreement

Public Water System I.D. No. 2200018

I. PURPOSE.
The City of Mansfield, Texas is responsible for protecting the drinking water supply from contamination or pollution which could result from improper private water distribution system construction or configuration. The purpose of this service agreement is to notify each customer of the restrictions which are in place to provide this protection. The utility enforces these restrictions to ensure the public health and welfare. In addition, when service to an existing connection has been suspended or terminated, the water system will not re-establish service unless it has a signed copy of this agreement.

II. RESTRICTIONS.
The following unacceptable practices are prohibited by State Regulations.
A. No direct connection between the public drinking water supply and a potential source of contamination is permitted. Potential sources of contamination shall be isolated from the public water system by an air-gap or an appropriate back flow prevention device that has been properly installed and tested.
B. No cross-connection between the public drinking water supply and a private water system is permitted. These potential threats to the public drinking water supply shall be eliminated at the service connection by the installation of an air-gap or a reduced pressure-zone back flow device that has been properly installed and tested.
C. No connection which allows water to be returned to the public drinking water supply is permitted.
D. No pipe or pipe fitting which contains more than .25% lead may be used for the installation or repair of plumbing at any connection which provides water for human use.
E. No solder or flux which contains more than 0.2% lead can be used for the installation or repair of plumbing at any connection which provides water for human consumption.

III. SERVICE AGREEMENT.
By submitting this form you are verifying that you are aware and agree to the terms of this water service agreement with the City of Mansfield, Texas.
A. The Water System will maintain a copy of this agreement as long as the customer and or the premises are connected to the Public Water System.
B. The Customer shall allow his property to be inspected for possible cross-connections and other potential contamination hazards. These inspections shall be conducted by a designated representative of the Public Water System prior to initiating new water service; when there is reason to believe that cross-connections or other potential contamination hazards exist; or after any major changes to the private plumbing or water distribution facilities. The inspections will be conducted during the Water System’s normal business hours.
C. The Water System shall notify the Customer in writing of any cross-connection or other potential contamination hazard which has been identified during the initial inspection or the periodic re-inspection.
D. The customer shall immediately remove or adequately isolate any potential cross connection or other potential contamination hazards on the premises.
E. The Customer shall, at their own expense, have any back flow prevention device properly installed, tested, and maintained, as required by the Water System and/ or State regulations. Copies of all testing and maintenance records shall be provided to the water system.
F. The Customer shall provide a copy of annual testing and maintenance report for all reduced pressure-zone devices and fire line systems. Residential Customers are required to maintain irrigation backflow prevention devices in good working order (double check valves), but are not required to submit annual inspection and maintenance reports.

IV. ENFORCEMENT.
If the Customer fails to comply with the terms of this Service Agreement, the Water System shall, at its option, either terminate water service or properly install, test, and maintain an appropriate backflow prevention device at the service connection. Any expenses associated with the enforcement of this agreement shall be billed to the Customer.

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Water Customer Service Agreement

Public Water System I.D. No. 2200018

I. PURPOSE.
The City of Mansfield, Texas is responsible for protecting the drinking water supply from contamination or pollution which could result from improper private water distribution system construction or configuration. The purpose of this service agreement is to notify each customer of the restrictions which are in place to provide this protection. The utility enforces these restrictions to ensure the public health and welfare. In addition, when service to an existing connection has been suspended or terminated, the water system will not re-establish service unless it has a signed copy of this agreement.

II. RESTRICTIONS.
The following unacceptable practices are prohibited by State Regulations.
A. No direct connection between the public drinking water supply and a potential source of contamination is permitted. Potential sources of contamination shall be isolated from the public water system by an air-gap or an appropriate back flow prevention device that has been properly installed and tested.
B. No cross-connection between the public drinking water supply and a private water system is permitted. These potential threats to the public drinking water supply shall be eliminated at the service connection by the installation of an air-gap or a reduced pressure-zone back flow device that has been properly installed and tested.
C. No connection which allows water to be returned to the public drinking water supply is permitted.
D. No pipe or pipe fitting which contains more than .25% lead may be used for the installation or repair of plumbing at any connection which provides water for human use.
E. No solder or flux which contains more than 0.2% lead can be used for the installation or repair of plumbing at any connection which provides water for human consumption.

III. SERVICE AGREEMENT.
By submitting this form you are verifying that you are aware and agree to the terms of this water service agreement with the City of Mansfield, Texas.
A. The Water System will maintain a copy of this agreement as long as the customer and or the premises are connected to the Public Water System.
B. The Customer shall allow his property to be inspected for possible cross-connections and other potential contamination hazards. These inspections shall be conducted by a designated representative of the Public Water System prior to initiating new water service; when there is reason to believe that cross-connections or other potential contamination hazards exist; or after any major changes to the private plumbing or water distribution facilities. The inspections will be conducted during the Water System’s normal business hours.
C. The Water System shall notify the Customer in writing of any cross-connection or other potential contamination hazard which has been identified during the initial inspection or the periodic re-inspection.
D. The customer shall immediately remove or adequately isolate any potential cross connection or other potential contamination hazards on the premises.
E. The Customer shall, at their own expense, have any back flow prevention device properly installed, tested, and maintained, as required by the Water System and/ or State regulations. Copies of all testing and maintenance records shall be provided to the water system.
F. The Customer shall provide a copy of annual testing and maintenance report for all reduced pressure-zone devices and fire line systems. Residential Customers are required to maintain irrigation backflow prevention devices in good working order (double check valves), but are not required to submit annual inspection and maintenance reports.

IV. ENFORCEMENT.
If the Customer fails to comply with the terms of this Service Agreement, the Water System shall, at its option, either terminate water service or properly install, test, and maintain an appropriate backflow prevention device at the service connection. Any expenses associated with the enforcement of this agreement shall be billed to the Customer.

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