BOTOLAN WATER DISTRICT

BATONLAPOC, BOTOLAN, ZAMBALES

EMAIL ADD: botolanwaterdistrict@gmail.com
Contact No.: 09491904735/09156411196

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BWD Form No.____

SERVICE APPLICATION

Applicant: _____________________________ Cellphone No.: _______________

Address: ____________________________________________________
House No. Street Barangay Municipality

I hereby apply for a water service connection, size ½ to be located at Barangay: ____________
____________________________. I understand the connection will not be made until it is
approved and all charges are paid and a contract for water service is duly signed. I assume
responsibility for the meter and all water that passes through the connection. I will conform to
the rules and regulation of the Botolan Water District.

_______________________ _________________
Signature of Applicant Date

Sketch and Location of Proposed Service

Please return this form at the Botolan Water District Office at National Road Brgy. Batonlapoc,
Botolan, Zambales.
Monday to Friday (except for Holidays)
8:00 a.m. to 4:00 p.m. only.

Who may avail of service?

Residents within the area of coverage of Botolan Water District.

Requirements:
1. Personal Appearance
2. Brgy. Clearance
3. Residence Certificate (Cedula)
4. Zameco Bill
 BOTOLAN WATER DISTRICT
BATONLAPOC, BOTOLAN, ZAMBALES
EMAIL ADD: botolanwaterdistrict@gmail.com
Contact No.: 09491904735/09156411196

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