Skip to Main Content
Do Not Show Again
Mandatory 20 Percent Reduction in Water Use and Restrictions in Effect
COVID-19 Health Orders in Effect
Departments & Services
How Do I...
Select a Category
City Clerk's Office
Commercial Loading Zone Permit
Housing and Community Services
Planning and Economic Development
Recreation & Parks
Santa Rosa Water
Transportation & Public Works
signing in or creating an account
, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.
Test Your Toilet
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
Local Businesses - Apply for FREE toilet dye tabs and toilet flappers below.
Delivery Address (Santa Rosa Businesses Only)
Name for Delivery
Please enter number of free toilet dye tabs or flappers you want to be delivered to your facility
Santa Rosa businesses only. Complimentary delivery may take up to 15 business days.
Toilet Flapper Quantity
*Requires a phone call with you to confirm that we provide the correct flapper for your specific toilet.
Toilet Dye Tab Quantity
Request information about FREE WaterSmart devices, services, and rebates.
Comments or Questions - We're here to help!
Leave This Blank:
Receive an email copy of this form.
This field is not part of the form submission.
* indicates a required field
Emergency & Preparedness Information
Slideshow Left Arrow
Slideshow Right Arrow