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.

    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