To initiate water service termination to a customer of the water company by reason of that customer's delinquent sewer charges payable to the borough, an authorized and responsible officer of the borough, as defined in § 167-14 herein, shall cause to be delivered to the water company a written request for termination, together with the following information and statements:
A.
The name and address of the sewer service customers.
B.
The address of the premises for which water service termination is sought.
C.
A statement that sewer charges relative to such premises remain unpaid for a period of at least 30 days from the due date thereof.
D.
A statement that the borough has fulfilled all applicable notice and procedural steps required of it by law, statute, regulations, ordinances and other authorities, including, without limitation, those mandated by the Sewer Act, 53 P.S. § 2261 et seq., and that the borough has not received written or other information the effect of which would be to make water service termination unlawful.