Training Request Form - Regional San

Post September 4, 2015

Participants in the Recycled Water Fill Station Project must read the Rules Governing the Use of Recycled Water and fill out the form below to request a training appointment.

Please note it takes 30 to 60 minutes to complete training.

Asterisk (*) denotes required field.

First name: *

Last name: *

Phone: *

Email: *

Choose 1st Preferred Training Date (Training starts June 21, 2023): *

NOTE: Training is provided ONLY Wed 3 to 5 pm & Sat 9 am to 1 pm

Choose a Back-up Training Date: *

Do you plan to use recycled water for your personal residence or for a business?: *

Personal residence

Business

What do you plan to use the recycled water for? (list all intended uses): *

What is the street address (or nearest cross streets) and city of the location(s) where you plan to apply the recycled water? (list all intended locations): *

What days of the week are you most likely to pick up recycled water?: *

How often do you plan to pick up recycled water?: *

How many gallons of recycled water would you like to pick up per visit? (The limit is 300 gallons at a time, unless a commercial truck. Note: Each gallon of water is around 8.5 lbs. We are not responsible for any damage to vehicles from overloading.): *

What is your preferred method of contact?: *

Phone

Other (please specify below)

Other :

How did you hear about Regional San’s Recycled Water Fill Station? (check all that apply):

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