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Tower Access Request Form

  1. BWA will respond to requests for tower access within 48 hours of submission.
  2. Enter the name of the primary on-site contact.
  3. Please upload a valid, government-issued photo ID for the Primary On Site Contact person.
  4. Enter the start date and time for the work.
  5. Enter the end date and time for the work.
  6. Enter the project or work order number.
  7. Please upload a copy of the work order.
  8. Elevated Tank Access
    Please note--contractors must provide their own equipment to access equipment on BWA elevated tanks. Contractors are not permitted to use the ladder on the elevated tank for tower access. Exceptions to this are access to Zollie Allen Elevated, Mont Del Elevated and Boston Elevated.
  9. Enter the name of the provider (AT&T, Sprint, Verizon, etc.)
  10. Enter the name of the Provider Representative for this project.
  11. Enter the email address for the Provider Representative for this project.
  12. Enter the phone number for the Provider Representative for this project.
  13. Enter the name of your company.
  14. Will there be other workers at the site?*
  15. Please enter the names of all workers who will be on site.
  16. Enter the license plate number of the vehicle that will be on-site.
  17. Additional Vehicles*
    Will there be additional vehicles on-site?
  18. Enter the license plate number(s) for the additional vehicles that will be on-site.
  19. Additional Equipment*
    Will there be additional equipment on-site (i.e. backhoe, lift, trencher)?
  20. Please list the additional equipment that will be on-site.
  21. IMPORTANT--PLEASE READ: By checking the "I Agree" box below, you agree and bind all contractors and individuals accessing Benbrook Water Authority ("BWA") premises to the terms of and compliance with the BWA Statement of Procedures document and the lease agreement between BWA and the telecommunications company for which the work is being done. this includes, but is not limited to, the indemnity and hold harmless provision in the BWA Statement of Procedure document and lease agreement. Checking the box below is also a certification that all statements made in the form are true and correct to the best of the applicant's knowledge and belief.
  22. Electronic Signature*
  23. Leave This Blank:

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