The TOTO Aquia IV Elongated Skirted Toilet Bowl with CEFIONTECT is designed for use with the Aquia IV tank. The skirted design conceals the trapway, which enhances the elegant look of the toilet and adds an additional level of sophistication. Skirted design toilets also minimize the need to reach behind the bowl to clean the nooks and crannies of the exterior trapway. When paired with its tank, the Aquia IV features TOTO's DYNAMAX TORNADO FLUSH(R), utilizing a 360 degree cleaning power to reach every part of the bowl. This version of the Aquia IV includes CEFIONTECT, a layer of ceramic glaze that minimizes waste from sticking to ceramic surfaces. This feature, coupled with the DYNAMAX TORNADO FLUSH, assists to reduce the frequency of toilet cleanings, minimizing the usage of water, harsh chemicals, and time required for cleaning. The enhanced design of the Aquia IV inner bowl reduces water flow resistance and turbulence, resulting in a quieter flush. When paired with its tank, the Aquia IV meets the standards for EPA WaterSense(R), and California's CEC and CALGreen requirements. The Aquia IV comes ready for install into a 12" rough-in, but may be adapted for a 10" or 14" rough-in with the purchase of a separately sold adapter. Additional items needed for installation and use must be purchased separately: compatibletank, wax ring, toilet mounting bolts, water supply lines, and toilet seat.