Leak Adjustment Request

Customer Name:

Service Address:

Account Number: (If Known)

Approximate date the leak was identified:

Date the leak was repaired:

Cell Phone/Main Contact Number:

Email Address:

Nature and Location of Leak:

Description of the repair work completed:

Attach supporting documents for the repair listed above, such as plumber's bill or receipt for parts (pdf, jpg or png - 10 mb max)

I have attached copies of all documents pertaining to the leak, including all repair receipts. Upon inspection, all leakage has been corrected and my consumption has decreased. I understand that I must allow 30 to 90 days for my adjustment to be processed. During this time, I will keep my overall balance below $100 each month or visit the office to set up a payment plan.

If you have a recurring payment set up in our online billing portal, please consider removing it until after the adjustment has been completed to avoid an unexpected full payment of your balance.

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