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Flume Program Interest Application

  1. Please Note: All information must be provided.

  2. Example: (xxx) xxx-xxxx

  3. Example: (xxx) xxx-xxxx

  4. *Your account number can be found on your water bill or by calling (909) 364-2660.

  5. *Must be less than 10,900 square feet

  6. Pre-qualification Questions:

  7. Do you acknowledge that this program requires you to purchase the Flume device for $40.*

    *The Flume device retails for $199 and is offered at major discount through this program.
    For more information, email the jloukeh@chinohills.org or call 909-364-2804.

  8. How did you hear about this program?*

  9. Property Owner Age Range:*

  10. Are you the homeowner or tenant*

    *Tenants may apply, but only with the permission of the property owner. Contact information for both parties MUST BE listed on the application.

  11. *Please provide any information that we should know about the property.

  12. Leave This Blank:

  13. This field is not part of the form submission.