Leak Adjustment Request

To request an adjustment for a leak, please fill out the form below. Please note the following criteria must be met to be eligible for adjustment per Regulation 1, Section 7. Leak adjustment requests must be made within six months from when the leak occurred. No more than one water bill will be adjusted among any 12 consecutive bills.

Customer's meter has been and is operating accurately
No evidence that excessive water delivery was caused by an intentional or negligient act of the customer
That upon becoming aware of the excessive water delivery the customer promptly took reasonable action to discover the cause and correct it

Water Account Number (format: 000-00000-00)

Name *

Phone Number *

Email *

Service Address *

Address Line 1

City

State

Zip Code

Approximate Date(s) Leak Was Discovered and Fixed *

Description of Leak or Excessive Water Use *

Additional Notes

Proof of Repair

Click or drag files to this area to upload. You can upload up to 3 files.

Attach any receipts, photos, or other proof of repair

Electronic Signature *

By selecting the "Submit" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement.