Leak Adjustment Request

Please fill in the form below and accept the terms before submission. Along with this form, you are required to attach your receipts and/or a letter from the company or person(s) who made the repairs. If you made the repairs yourself and no receipt is available, then you are required to provide a statement specifying what, when and where repairs were made.

You may also download and complete our leak adjustment packet instead.

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.

Please click the image below for more details about our leak adjustment process:

Haga clic en la imagen a continuación para obtener más detalles sobre nuestro proceso de ajuste de fugas: