Scotts Valley Water District Dist water by benbenzhou


More Info
									                                                Scotts Valley Water District                               District Use Only
                                                                                                           Customer # __________________
                                      P.O. BOX 660006 SCOTTS VALLEY, CA 95067-0006
                                             (831) 438-2363 FAX (831) 438-6235                             Service Order # ____________
                                                  EMAIL:                                      □ Approved      □ Denied
                                                                                                           Credit Amount $_______________

                             Water Efficient Fixtures Account Credit Application
Name on Account: ___________________________________________________________________________________________
(Person to receive credit)
Contact Person:          _________________________________________________             □ Owner          □ Tenant
Day Phone: _________________________________________            Cell Phone: _________________________________________

Service Address          : _________________________________________________________________________________________

Customer Account Number: _____________________________          Date of Replacement: _________________________________
(Located on your water bill)

□ Washing Machine – commercial (Up to $200 Credit)              □ Washing Machine – residential (Up to $100 Credit)
(Energy Star® approved)                                         (Energy Star® approved)
New Manufacturer: _____________________________                 New Manufacturer: ____________________________
New Model:         _____________________________                New Model:        ____________________________
Old Model:         _____________________________                Old Model:        ____________________________

□ Toilet (Up to $200 Rebate) Quantity: ____________             □ Toilet (Up to $100 Rebate) Quantity: ____________
(Replacing over 1.6 gallon per flush or higher with HET)        (Replacing 1.5 or 1.6 gallon per flush with HET)
Old Manufacturer: ____________________________                  Old Manufacturer: ____________________________
Old Model:         ____________________________                 Old Model:          ____________________________
New Manufacturer: ____________________________                  New Manufacturer: ____________________________
New Model:         ____________________________                 New Model:          ____________________________
Purchase Price: ____________________________                    Purchase Price: ____________________________

□ Urinal (Up to $200 Rebate)                                    □ Urinal (Up to $100 Rebate)
(Replacing water-using urinal with waterless urinal)            (Replacing higher volume urinal with high efficiency urinal)
Old Manufacturer: ____________________________                  Old Manufacturer: ____________________________
Old Model:         ____________________________                 Old Model:         ____________________________
New Manufacturer: ____________________________                  New Manufacturer: ____________________________
New Model:         ____________________________                 New Model:         ____________________________
Purchase Price: ____________________________                    Purchase Price: ____________________________

□ Smart Irrigation Controller (Up to $500 Rebate)               □ Turf Replacement ($1/ft2 up to 1000 ft2 - $.30 after)
(Replacing old controller with ‘weather based’ controller)      (Replacing lawn with artificial turf or xeriscaping)
Old Manufacturer: ____________________________                  Old Lawn Type: ____________________________
Old Model:          ____________________________                New Landscape: ____________________________
New Manufacturer: ____________________________                  Irrigation Method: ____________________________
New Model:          ____________________________                Landscape Area: ____________________________
Purchase Price: ____________________________                    Purchase Price: ____________________________

□ Cistern Installment (Up to $500 Rebate)
(Installing a cistern to catch rain for landscape irrigation)
Cistern Model:         ____________________________
Storage Capacity: ____________________________
Installated By:        ____________________________
Purchase Price: ____________________________
Water Efficient Fixtures Account Credit Program Terms and Procedures
Devices must be purchased and installed no more than 90 days prior to submitting application

▪ A HET uses an average of 1.28 gallons per flush or less. A high efficiency urinal uses .5 gallons per flush or less.
▪ Confirm that the device(s) is/are identified on the list of approved products. For ULFT/HET/DFT/URINAL rebates,
the model numbers for both tank and bowl must be on the list. For clothes washer(s), the device(s) must have a
water factor of 6.0 or less.
▪ Please visit or call the district at (831) 438-2363 to confirm eligibility for toilet and washer rebates.
▪ Smart controllers estimate or measure depletion of available plant soil moisture in order to operate an irrigation
system, replenishing water as needed while minimizing excess water use. A properly programmed smart controller
requires initial site specific set-up and will make irrigation schedule adjustments, including run times and required
cycles, throughout the irrigation season without human intervention.
▪ Credit of $1.00 per square foot up to 1000 square feet of high water using lawn replaced with artificial turf and/or
drought tolerant plants. Each additional square foot will qualify for a $0.30 credit up to $2,000.
▪ Replacement turf must be pervious and participants must agree to leave the new landscape or turf in place for a
minimum of five (5) years.
▪ Rebates of $25 for each 100 gallons of rainwater storage capacity in a cistern system (up to a maximum storage
capacity of 2,000 gallons). Rebate applies to material only, no labor costs. Original receipt must accompany rebate
credit application. Customer must allow a post installation inspection. Backflow protection is required on any storage
tank to be used to store rainwater exceeding 250 gallons. Follow all permitting and zoning laws. A permit from the
planning department at the County is required if container is over 5000 gallons or the height to width exceeds a 2 to 1
▪ Mail or fax your completed rebate application along with receipt to Scotts Valley Water District.
▪ Applications for rebate must be submitted within 90 days of the purchase date shown on the receipt.
▪ Approved applications appear as a credit applied directly to your account. Under no circumstance does the district
issue cash or check refunds.
▪ Rebate credits are applied to the account associated with the service address where the replacement was made. If
you are a property owner and you are applying for a rebate on a replacement made at a location where the water bill
is in the tenant’s name, the rebate will be applied to that tenant’s account.
▪ A representative of SVWD must be permitted to inspect the property to verify installation if necessary.

Signature: ______________________________________                          Date: ____________________

To top