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Backflow Device Removal Eligibility Questionnaire. 


If you answered YES to ANY of these questions DO NOT submit this form.

If you answered NO to all of these questions please submit your name and contact information to discuss having your device removed.
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DO NOT CLICK ON SUBMIT IF YOU ANSWERED YES TO ANY OF THE QUESTIONS ABOVE.

If you select submit, one of our staff will follow up with you to discuss the details for removing your device. For any other backflow-related questions or concerns please contact our Backflow Specialist at (760) 728-1178 extension 212 or via email at crossconnectionbackflow@rainbowmwd.com.