Leak Adjustment Request Form

Leak Adjustment Request
Please reference the District's Leak Adjustment Policy above. (it is only two pages long)

To submit a request for a leak adjustment according to this policy please complete the form below. (Submit button is at the bottom of the page).  Leak adjustments are processed once a month immediately following billing.  Billing occurs on the third Wednesday of each month.

Please note District policy only allows for one leak adjustment per customer every two years, and is limited to a maximum credit of $500 for qualifying leaks.

*Indicates a field is required.
 

* Date of Request:

* Account number:

* Name on Account

* Email

* Contact phone:
 
* Physical address for the property

Mailing Address if different

* Date leak was noticed

* Date of leak repair

*Service Line Material


*Description of repairs made.