Devices Received

Please fill out this form to confirm the water-efficient device(s) your site received.

Confirm Amount of Pre-Rinse Spray Valves:

Confirm Amount of Faucet Flow Restrictors:

Comments?

I confirm I received the devices my site qualified for in its C4K participation.

I understand that I may be contacted if there is an issue with this form.

Electronic Signature

Please fill in all required fields