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Fire Department Authorized Use Form

The Connecticut Public Utilities Regulatory Authority requires reporting of all authorized hydrant usage.

The data gathered is for PURA compliance and is NOT used to generate billing.

Block Group

Form Block

Person Reporting Usage

First Name *

Last Name *

Phone Number *

Email *

Reason for Usage *

Fire Department Training

Fire Fighting

Other

Water Used

Street *

City/Town of Water Use *

Date of Water Use *

Number of Hydrants Used *

Do You Know Volume of Water (in gallons) Used? *

Yes
No

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