1 Customer Details 2 Site Details 3 Thank You Name * Phone * Email * Address Town/City Postcode Preferred Contact Time 8:30 9:00 9:30 10:00 10:30 11:00 11:30 12:00 12:30 13:00 13:30 14:00 14:30 15:00 15:30 16:00 16:30 17:00 17:30 18:00 18:30 19:00 19:30 20:00 20:30 21:00 21:30 22:00 Next Do you have an external stopcock? * Please Select Yes No Not Known Diameter size of existing supply pipe Please Select 20mm (0.5") 25mm (0.75") 32mm (1") 50mm (1.5") 63mm + (2") Material of exisiting supply pipe Please Select Galvanised Iron Lead Copper Poly PVC Not knowm Previous Next Length of supply from boundary (1) to property (2) Regulation break through required? Please Select Yes No Not known Type of property Please Select Flat Maisonette Terraced Semi-detached Detached Length of supply pipe from property (2) to internal stopcock(3) Additional information Previous Submit Thank you {Name|name_4_1}Form Submitted Successfully!We will contact you as soon as possible.