I understand that by completing this form, I am formally requesting Guernsey Water to permanently disconnect the above supply from the mains in the road and remove the meter chamber and service pipe. 
 
I am aware that whilst there is no charge for the permanent disconnection of the service, should a new service be required at the above site within 5 years of the date below, Guernsey Water will retrospectively charge me for all work carried out in respect of removing the original service, as well as the full cost for the installation of a new service.