1 Start 2 Complete Loudoun Water's Hydrant Meter Program operates Monday through Thursday, from 8:00 AM to 4:00 PM. For any questions or concerns regarding hydrant meters, please contact Loudoun Water Customer Relations at 571-291-7880 or customerservice@loudounwater.org Why Do You Need a Hydrant Meter? Truck/Tank Fill Landscaping Construction Water Masonry Facility Commissioning/Testing Temporary Sanitary Sewer Discharge Other Number of Tanks/Trucks? Describe the Use of the Hydrant Meter Provide Project Address Enter Your Loudoun Water Project ID #. Enter the Loudoun Water Inspectors Name (If Available) - None -Jay BaltzerTimothy BowlesMichael BurrowsKaleb DanBradley FlemingJason FranklinRobb GouldWilliam"Tanner" MadiganBryan MontgomeryAaron MoviusMatt OwensMatt ParksGary PateMike SanfordSidney "JJ" VirtsWesley Walker Do You Have a Backflow Protection? Yes (Air Gap) Yes (RPZ) No What Meter Size Do You Need? 3 inch ($2,090) 3/4 ($400) Estimated Duration of Project (Provide an Estimated End Date) Billing Information Company Name Billing Address City State - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code Company Phone Company Email Contact Person Information Company Contact Person (Name and Title) Mailing Address (If Different from Billing Address) City State - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code Contact Person Work Phone Contact Person Mobile Phone Contact Person Email Additional Contact Person Information Name Email Address File Upload Please Upload the Following Files: Valid, State Issued Identification Card (ie: Driver's License) Business Card (Including the Company Name and the Name of the Person Picking Up the Hydrant Meter) Business License - Virginia or Loudoun County Copy of your Federal Tax Identification Number (Copy of your W-9) Valid, State Issued Identification Card Upload More Information Business Card Upload More Information Business License Upload More Information Copy of Your Federal Tax Identification Number (W-9) Upload More Information After submission of this form, a confirmation email is automatically sent to the requestor. NOTE: If no confirmation email is received within a few minutes, or you experience any issues with the form, please send an email to: HydrantMeterRequest@loudounwater.org Submit