Once a year should be plenty. I prefer to do it in the fall when winterizing. One less thing to do in the spring. I use the heated vinegar overnight method, then flush with the Camco wand. Gets a good amount of crud out. How often you use the trailer and hot water obviously has an impact, as well as how hard the water is where you go. Here in the West, most water sources are fairly hard. I do use an external filter, not sure if that impacts hardness much but I do notice I don't get deposits in my sinks when they get wet so it must help some.
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