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2. BUSINESS SERVICE APPLICATION
   • Business Hours: Mon-Thurs 7:00 am - 6:00 pm
   • Phone: (855) 654-CVWD
4. General Information
6. Name of Company*
8. Service Address*
10. Property Type:*
    -- Select One --ResidentialCommercial

    If you selected "commercial" as the property type, please answer the following two questions: 

12. Please check the box to activate the following service:*

    1. Domestic
    2. Fire Line
    3. Landscape
14. Business Type/Activity- Sewer*
    -- Select One --BakeryBar/Tavern without foodBar/Tavern with diningCar WashChurch/WorshipConvalescent facilityDaycare centerDental officeDoctor officeDry CleanerFire StationHealth spaHospital - full serviceHotel with diningLaundromatLaundry - commercial/industrialManufacturingMarket with grinderMarket without grinderMortuaryMotel with diningMotel without diningOfficeOutpatient facilityPublic facility with diningPublic facility without diningRecreation/Amusement with diningRecreation/Amusement without diningResidential Rental PropertyRestaurant - fast foodRestaurant - full serviceRetail/ServiceSchool - Public/Private:  Kindergarten through 12 th gradeSchool - Public/Private: CollegeWarehouse
16. Business Type/Activity- Water*
    -- Select One --Banking/Financial ServicesEducationEntertainment/Public AssemblyFood Sale and ServiceHealth CareLodging/ResidentialManufacturing/IndustrialMixed-useOfficeParkingPublic ServicesReligious WorshipRetailTechnology/ScienceServicesUtilityWarehouse/StorageOtherLaundromatWater RecreationStandalone Car WashCar Dealership Car WashCar Wash with Gas StationCar Wash & Repair Shop
18. Please describe what operations or business is performed at this location.*
20. Will you manufacture any items at this location?*

    1. Yes
    2. No
22. If you answered yes, please list what you will be manufacturing; if you answered no, please put n/a.*
24. Please Identify your legal position to this property.*

    1. Owner
    2. Tenant
    3. Property Manager
    4. Resident
26. Contact First Name:*
27. Contact Last Name:*
29. Contact Email:*
30. Phone:*
32. Tax ID:*
33. Start Date:*
    Start Date:
35. Billing Address:*
37. Name of Responsible Party:*
41. Backflow Information
43. Facilities Contact Name: *
44. Phone:*
46. Mailing Address:*
48. Document Upload if Required:
50. Please select one of the options below for your turn-on request:*

    1. Next Business Day Turn-On is $15 per account
    2. Same Business Day Turn-On is $25 per account

    Please note our Business hours are Monday through Thursday 7:00am - 6:00pm. 

    We are currently experiencing a delay in processing applications. Please allow additional business days to process your request. 

52. • We charge at minimum a $175.00 deposit for Domestic and Landscape accounts.

    • Please ensure all faucets and water fixtures are off prior to your request for turn-on. Fixtures that are left on will result in us being unable to leave water on, and an additional charge will be assessed.

    Thank you for contacting Cucamonga Valley Water District.

Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit

* indicates a required field