Customer Name* First Last Email Address Contact Phone NumberService Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date Flushing Occurred* MM slash DD slash YYYY Time Flushing* Hours : Minutes AM PM AM/PM To* Hours : Minutes AM PM AM/PM Please provide any additional information below such as additional dates and times that flushing occurred:*Please note: Customers in affected areas that are experiencing water quality issues and advised by our staff to flush/run their water lines to clear out discolored water may be eligible for a credit on their bill. Daphne Utilities will review and verify water consumption records from the date and time provided above to determine how much of a credit you may be eligible to receive. For additional assistance please contact our main office at (251) 626-2628, Option 3.To protect our site and your information against spam bots and to let us know that you are a real human, we have added an extra security measure of verification.CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.