DIY Water Wise Indoor Survey Worksheet | Santa Clara Valley Water
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DIY Water Wise Indoor Survey Worksheet

Provide the number shown on the dial or meter’s face.
Does your water meter register when all your water using fixtures and appliances are turned off?

 
The House Line Test: Does the irrigation system branch off the house line before the house line shut-off valve?
Does the irrigation system branch off the house line before the house line shut-off valve?
 
Does the irrigation system have a shut-off valve?
After you turn off the house line and do a second Pin Test: Is there movement?
Turn on the house line valve using the same number of turns you to turn it off.

 
Did you find any leaks indoors?
Any signs of standing water damage?
Any signs of leakage or water damage?
Questions Yes No
Questions Yes No
Questions Yes No
Questions Yes No
Showers: Do your showerheads use more than 2.0 gpm?
Enter the highest flow rate
Enter the next-highest flow rate
Do your bathroom sink faucets use more than 1 gallon per minute (gpm)?

If you found you have different flow rates throughout your home, enter the highest flow rates in ‘A’, then the next highest flow rate in ‘B’. If you have more than two flow rates,
please provide any additional details in the ‘Comments’ at the end of this form.
Enter the highest flow rate
Enter the next-highest flow rate
Do your kitchen sink faucets use more than 1.5 gallon per minute (gpm)?
Enter the highest flow rate
Enter the next-highest flow rate
Please note we will send you efficient faucet aerators, showerheads or toilet flappers based on your responses above, which may be less than what you specify below.
For a 2.0 gpm showerheads, enter the quantity you want. Otherwise, check your local hardware store for even more efficient WaterSense-labeled showerheads.
Is there any sign of water damage around your appliances?