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THE
LAWN WHISPERER
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Toilet Replacement Program
FREE
TOILET REPLACEMENT
PROGRAM
Dallas Water Utilities now offers its customers FREE high-performance toilets that help reduce water consumption.
More information
Industrial, Commercial, and Institutional (ICI) Water Conservation Program
INDUSTRIAL, COMMERCIAL, & INSTITUTIONAL (ICI) PROGRAM
City of Dallas
Water Conservation offers programs to help businesses and public facilities save water and money.
More information
Dallas Hospitality Industry Program
DALLAS HOSPITALITY INDUSTRY PROGRAM
City of Dallas
Water Conservation has a
FREE
program to help Dallas hotels, motels and restaurants conserve water.
More information
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Saturday, June 1, 2013
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Save Dallas Water
» Toilet Replacement Application Form
Toilet Replacement Application Form
Option (choose one):
*
Toilet voucher (FREE toilets)
Toilet rebate (credit on water bill - multi-family and condo residences NOT eligible for rebate)
Dallas Water Utilities account number (9-digit number with no spaces or dashes):
*
Please enter a value between
100000001
and
999999999
.
Type of residence:
*
Single family
Duplex
Triplex
Fourplex
Condominium
Year home was built:
*
Last name:
*
First name:
*
Daytime telephone:
*
Service address (where toilets will be installed):
Street number:
*
Direction (e.g., N, E, SW, NE):
N
S
E
W
NE
NW
SE
SW
Street name:
*
Unit or Apt. #:
City:
*
Zip code:
*
Mailing address (if different from above):
Street number:
Direction (e.g., N, E, SW, NE):
N
S
E
W
NE
NW
SE
SW
Street name or P.O. Box:
Unit or Apt. #:
City:
State:
Zip code:
Homeowner name (if different from customer name):
Homeowner daytime telephone (if different from above):
Number of toilets in home:
*
Number of toilets to be replaced:
*
1
2
Number of household occupants:
*
Gallons per flush (GPF) old toilet #1:
3.5
5.0
7.0
Gallons per flush (GPF) old toilet #2:
3.5
5.0
7.0
How did you hear about the program?
*
Mailer
Newspaper
Radio
Dallas Water Utilities website
Other
E-mail:
*
Attachments:
Attach a copy of your toilet purchase receipt(s) if applying for a rebate. Attach a landlord consent letter if this is a rental property (accepted formats - .pdf, .jpg, .gif, .tif, .bmp):
I hereby certify that I am a City of Dallas Water Utilities customer or property owner authorized to replace the toilets at the address listed above. All toilets being replaced are models that flush 3.5 gallons or more. I understand that I am responsible for installation and for disabling and disposing of the replaced toilets. I agree to a post-installation verification. The City of Dallas does not guarantee toilet performance or workmanship.
*
I agree
I do not agree
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