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Water Efficiency Rebate Form

Untreated Water Tank

Contact Information

Rebate Information

Acknowledge Terms & Conditions

I have read, understand, and agree to the Placer County Water Agency Untreated Water Tank Rebate Terms and Conditions.

I understand that PCWA reserves the right to have an Agency representative verify the installation of the product(s) at the service address on the application.

Release of Liability & Signature

Placer County Water Agency (PCWA) reserves the right to deny an application of any participant who does not meet all requirements as outlined. PCWA reserves the right to change the terms of this program at their discretion. PCWA cannot guarantee that the installation of the product(s) will result in lower water utility costs. The number of rebates is dependent upon the availability of program funds. Applications will be processed when all required information is provided by the applicant on a first-come, first-served basis.

You must sign this form by typing your name

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