Cibola Service Form - D&R Plumbing

Hello Cibola!

Cost to test will be $85.00 COD, or prepaid in advance. This includes filing paperwork with the water company and any follow up if needed.

Please return or submit the form with your payment & I’ll do the rest. To schedule your test with COD payment, contact 909 627-2697, email me at mike@d-r-plumbing.com or mail to D & R Plumbing 12726 Roswell Ave Chino, CA 91710. Be sure to provide the information below as it appears on your water bill.

The backflow preventers in Cibola are starting to need work. In an effort to keep costs down and to
expedite repairs, I have attached a price list below for repairs if needed at the time of testing. These prices are only valid at time of testing. If you choose not to pre- approve repairs, cost to repair will be
higher. If the device is not serviceable, I will contact you for approval prior to replacement.

Name

Phone

Water number

Mailing Address

Service Address (backflow location)

Approval:

Pre- Approval: I hereby approve any repairs if deemed as needed by the test results of the initial test. Repair costs will be billed and due upon completion of repairs. I will contact you for approval prior to commencement of work if device needs to be replaced. Please provide payment method. I decline pre-authorization of repairs at this time, which will cause an increased cost to repair if the device fails the initial test.
Common Repair Costs:

Clean & retest $85.00
Clean, rebuild, & retest 975XL 1" or 3/4 device $255.00
If seats are needed add $25.00 per seat
Brass Test cock replacement $28.00 ea
If 3/4 or 1" devices are not serviceable and needs replacement $1175.00