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    Request For Certificate of Interconnection Form

    Uploaded by

    Juvy Ann Poblete
    This request form is for a certificate of interconnection from Laguna Water Corporation. It collects information about the company such as name, address, account number, type of business, and contact details. It also requests the purpose of interconnection and details of the landlord if the applicant is a tenant. The form is to be filled out by the business area team to provide consumption data and billing information. It is also to be filled out by the used water services team to provide sampling and testing details. Final approval is noted by the business zone manager.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Request For Certificate of Interconnection Form

    Uploaded by

    Juvy Ann Poblete
    262 views1 page
    This request form is for a certificate of interconnection from Laguna Water Corporation. It collects information about the company such as name, address, account number, type of business, and contact details. It also requests the purpose of interconnection and details of the landlord if the applicant is a tenant. The form is to be filled out by the business area team to provide consumption data and billing information. It is also to be filled out by the used water services team to provide sampling and testing details. Final approval is noted by the business zone manager.

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    Request for Certificate of Interconnection Form

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    This request form is for a certificate of interconnection from Laguna Water Corporation. It collects information about the company such as name, address, account number, type of business, and contact details. It also requests the purpose of interconnection and details of the landlord if the applicant is a tenant. The form is to be filled out by the business area team to provide consumption data and billing information. It is also to be filled out by the used water services team to provide sampling and testing details. Final approval is noted by the business zone manager.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    262 views1 page

    Request For Certificate of Interconnection Form

    Uploaded by

    Juvy Ann Poblete
    This request form is for a certificate of interconnection from Laguna Water Corporation. It collects information about the company such as name, address, account number, type of business, and contact details. It also requests the purpose of interconnection and details of the landlord if the applicant is a tenant. The form is to be filled out by the business area team to provide consumption data and billing information. It is also to be filled out by the used water services team to provide sampling and testing details. Final approval is noted by the business zone manager.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    Request Form

    Certificate of Interconnection

    Company Name: _______________________________________________________________________________


    Address: ______________________________________________________________________________________
    ______________________________________________________________________________________
    Laguna Water Contract Account Number: __________
    LTI Locator since: ____ / _____ / _________ (mm/dd/yyyy)
    Type of business: _______________________________________
    Name of Company Representative: ___________________________________
    Contact Number: _______________________________
    Purpose: _______________________________________
    To be filled up if tenant:
    Company name of Lessor: _______________________________________________________________
    Tenant since: ____ / _____ / _________ (mm/dd/yyyy)

    ______________________________
    Signature

    To be filled up by LAWC Business Area Team: To be filled up by LAWC Used Water Services Team:

    Last 3 months’ average consumption: Sampling Date: _________________ (mm/dd/yyyy)


    Industrial: _____________ cu.m. Remarks: _____________________________________
    Domestic: _____________ cu.m. _____________________________________________
    Average Monthly bill: Php _____________________ Dye Testing result: _____________________________
    PUA: Php ________________________ Approved (Y/N): _______________________________

    ______________________________ ______________________________
    Name and Signature Name and Signature
    Territory Manager Facility Manager
    Noted by:

    _____________________________________
    Business Zone Manager

    LAGUNA AAAWATER CORPORATION


    A Joint Venture of the Provincial Government of Laguna and Manila Water Company
    2/F Banawe de Sta. Rosa Building, F. Reyes St., Balibago, Sta. Rosa City, Laguna 4026
    Telephone Number: (049) 534 1627 · (02) 519 4887

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