BBH - Owner of single family home

Required fields are marked with asterisks (*)

Blue Built Home Certification and Rebate Claim form

Owner of a single-family home

For owner of a newly built single-family home that builder has constructed according to Blue Built Home certification requirements.

Applicant information

First name

Last name

Main phone

Address

Street address

City

Postal code

Hydro bill account number

Number of people living in the house

I have had a residential water audit

Yes

Blue Built Home certification requirements

Please select all of the Blue Built Home requirements you meet. Provide as much information as you can about the products including those completed before, during or after your residential water audit:

Rainwater harvesting system

Greywater reuse system

Three of the following options. At least two options must be from the primary category. Please identify the number of each fixture, appliance or system you have that meets the Blue Built Home requirements.

Primary options

Water Sense® toilet(s) less than or equal to 4 litres per flush

Toilet quantity

Manufacturer name

Model number

Add toilet Remove toilet

Energy Star® washing machine less than or equal to 19 litres per person per day

Washing machine quantity

Manufacturer name

Model number

Add washing machine Remove washing machine

Energy Star® dishwasher

Dishwasher quantity

Manufacturer name

Model number

Add dishwasher Remove dishwasher

WaterSense® showerheads with a maximum flow rate of 6.6 liters per minute

Showerhead quantity

Manufacturer name

Model number

Add showerhead Remove showerhead

Efficient hot water distribution system

Installed on-demand recirculation system

Recirculation system quantity

Manufacturer name

Model number

Add recirculation system Remove recirculation system

Pipelengths meets Blue Built Home requirements

Yes

Secondary options

WaterSense® lavatory / bathroom faucets with a maximum flow rate of 5.7 litres per minute.

Faucet quantity

Manufacturer name

Model number

Add faucet Remove faucet

Lavatory faucet aerators with a maximum flow rate of 5.7 liters per minute.

Aerator quantity

Manufacturer name

Model number

Add aerator Remove aerator

Permanent sub-water meter

Permanent sub-water meter quantity

Manufacturer name

Model number

Add sub-water meter Remove sub-water meter

Removable/temporary sub-water meter

Removable/temporary sub-water meter quantity

Manufacturer name

Model number

Add sub-water meter Remove sub-water meter

Waterless floor drain trap primer

Floor drain trap primer quantity

Manufacturer name

Model number

Add floor drain trap primer Remove floor drain trap primer

Blue Built Home Healthy Landscapes visit?

Yes

Other water efficiency option as approved by the City of Guelph

To receive any rebates and the Blue Built Home certification, you must provide proof of purchase for all water saving features you have bought and installed to meet the Blue Built Home requirements. Your total rebate is calculated based on the allocations per fixture, or appliance and/or system as verified through proof of purchase dated no more than one year from the submission of this form. The City of Guelph may request a site visit to confirm the installation of water saving products.

Please upload proof of purchase if you are claiming a rebate for a washing machine, dish washer, sub-water meter, or other water efficiency option as qualifies for this program and as approved by the City of Guelph.

Upload proof of purchase(s)

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Terms and conditions

I have read, understand and agree to the terms and conditions of the Blue Built Home Program

Agree

I certify that I have bought and installed the water saving features indicated in this application.

Agree

I pledge to be water wise and uphold the values of the Blue Built Home program

Agree

How did you hear about the program?

Collection of personal information

Personal information, as defined by the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA) is collected under the authority of the Municipal Act, 2001, and in accordance with the provisions of MFIPPA. Personal information on this form will be used for the purpose of processing Blue Built Home Certification and Rebate Claims.

If you have any questions regarding the above program please contact Water Services at 519-822-1861 extension 2116 or bluebuilthome@guelph.ca.

If you have questions about this collection; use, and disclosure of this information, contact the City of Guelph’s Access, Privacy and Records Specialist at 519-822-1260 extension 2349 or privacy@guelph.ca.