Hydrant Usage Report Form

Iredell Water Corporation



Hydrant Usage Report


Complete the following information. Make additional copies of this form for later use. Form must be completed and submitted within twenty-four (24) hours of hydrant usage. Include all water used from any attending Fire Department.

Contact Name*
:
Contact Number
:
Email Address*
:
Fire Department
:
Location of hydrant(s) used (Include Street & cross Street. Also include Hydrants(s) ID if available)
:
Date of hydrant usage
:
Start Time (24 hr)
: :
End Time (24 hr)
: :
Reason for hydrant usage (Structure Fire, Grass Fire, Training Burn, etc. & location of usage
:
Estimate of Total Gallons Used
:
Additional Information or notes
: