According to police, the crash happened around 11:40 a.m. Monday in the area of U.S. 290 Northwest Freeway and N. Gessner.
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Witnesses told police the white water truck was heading westbound on the service road when it blew through the intersection.
A GMC Sierra was heading northbound on N. Gessner when it was hit, police said.
The impact caused the GMC to push a Toyota Avalon that was heading southbound.
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Two people were inside the GMC, including the 79-year-old passenger. The person behind the wheel of the Sierra and the drivers of the other vehicles were taken to the hospital. Investigators are looking at speed as a factor in the crash.
The district attorney's office said the driver of the water truck is expected face at least a traffic citation and possibly additional charges.
Investigators are also expected to look at camera footage from the water truck's cabin.