Water Utilities Distribution - Shut Down Request Form

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Please correct the field(s) marked in red below:

Water shut down request forms need to be sent via email to:

This form shall be submitted 10 working days in advance of any requests to shut down any lines in the City of Peoria's potable water distribution system. The form is to be submitted through the Engineering Off-Site Inspector assigned to the project, who will in turn coordinate with necessary Utility staff. Failure to complete the form will result in delays to construction activities. Utilities does not guarantee a dry shut down.

Description of Shut Down Request

Below to be completed by Field Operations

 Hansen Service Request:  
 Test Shut Down Verified on What Date:  
 Test Shut Down Performed by:  
 Contractor and Inspector Notifications Date:  
 Contractor and Inspector Notifications Time:  
 Shut Down Email Notifications Made by:  
  1. To receive a copy of your submission, please fill out your email address below and submit.