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Please Print and Mail form to:
        HARFORD COUNTY GOVERNMENT
        NEW CONNECTION SERVICES
        212 SOUTH BOND STREET
        BEL AIR, MD 21014
        410-638-3300, FAX 410-638-3024

Fixture Count Values - Commercial & Public

Name of Business:
Address: 

Permit #: 

Fixture   Quantity
Bathroom Sink Commercial
  Public
Water Closet Commercial Toilet w/tank
    Flush Valve - no tank
  Public Toilet w/tank
    Flush Valve - no tank
Urinal Commercial Tank
    Wall
    Pedestal
  Public Tank
    Wall
    Pedestal
Bidet Commercial  
  Public  
Bath Tub Commercial  
  Public  
Shower Commercial  
  Public  
Hand/Kitchen Sink Commercial  
  Public  
2 or 3 Compartment Sink Commercial  
  Public  
Mop, Service, Hair, Pre-rinse, Dish or Bar Sink
Bradley Sink
Laundry Tub
Washing Machine
Dish Washer General  
  Pots & Pans  
Steam Table
Garbage Disposal
Ice or Soda Machine
Ice Tea or Coffee Machine
Water Fountain Commercial
  Public
Hose Bib (Wall Hydrant)
Fire Sprinkler System
Other (indicate line size)
Other (indicate line size)
Other (indicate line size)

 

 

Prepared By:____________________________________________ Date:______
Please Print Name and Telephone No.

Line Size
1/4"
3/8"
1/2"
3/4"
1"

W/S Form A-13
Revised 1/97

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