Please complete the application below to disconnect service.

If you have questions regarding disconnecting service, please Email Customer Service or call during normal business hours (865) 577-4497.

AIR GAP (AG), REDUCED PRESSURE (RP), DOUBLE CHECK (DC).
PRESSURE VAC (PV), DOUBLE DETECTOR CHECK VALVE (DDCA)

1. Does facility have an auxiliary water supply? YesNo
Is facility interconnected to the public water system? YesNo
2. Hazardous materials on premises? YesNo
Water connected? YesNo
3. Special uses/equipment requiring water at all times? YesNo
4. Heating/cooling systems - water connected? YesNo
a. Air Conditioners YesNo
b. Boilers YesNo
c. Chillers YesNo
d. Cold Storage YesNo
e. Cooling Towers YesNo
f. Heat Exchangers YesNo
g. Refrigeration YesNo
h. Water Cooled Condensers YesNo
i. Water Cooled Equipment YesNo
j. Other:
5. Industrial Fluids/Pressure Systems - Water Connected: YesNo
a. Booster Pumps YesNo
b. Circulation Pumps YesNo
c. Hydraulic Lines YesNo
d. Hydro-Pneumatic Systems YesNo
e. Priming Lines YesNo
f. Steam Lines YesNo
g. Other:
6. Chemical Injection/Feeder Systems - Water Connected: YesNo
a. Corrosion/Scale Inhibitors YesNo
b. Algae/Micro-Organism Biocides YesNo
c. Soaps YesNo
d. Softeners YesNo
e. Other:
7. Irrigation Systems: YesNo
a. Chemical/Fertilizer Injection YesNo
b. Booster Pumps YesNo
c. Separate Service Connection YesNo
d. Other:
8. Laboratory Facilities - With Water Connected Equipment YesNo
9. Kitchen Facilities (Commercial) YesNo
10. Photo Processing/Printing Equipment - Water Connected (Commercial) YesNo
11. Plating Facilities (Commercial) YesNo
12. Reclaimed Water/Solvents YesNo
13. Swimming Pool/Spa: YesNo
a. Chemical Additives YesNo
b. Low Level Inlet YesNo
14. Tanks, Vats, or Other Vessels Containing Non-Potable Substances: YesNo
15. Fire Protection Systems - Connected To Public Water: YesNo
a. Unapproved Auxiliary Water Supply Available? YesNo
b. Elevated Storage Tanks/Private Reservoirs? YesNo
c. Hazardous Substance(s) in Fire System? YesNo
d. Interconnection With Another Water System Service? YesNo
e. Other
Comments
Required Service Line Protection (AG, RP, DC, DDC, NONE)
Domestic
Fire
Irrigation
Inspector
Date