Leak Adjustment Request Form

2. Leak Adjustment Guidelines
   • Accounts that are individually metered for potable/irrigation water are eligible for an adjustment. Reclaimed meter leaks are not eligible for any adjustments.
   • To be considered for an adjustment, the high consumption amount must be at least 20,000 gallons above the account average or double the account average for the past 12 months.
   • Only one leak adjustment will be considered for any given twelve-month period per account location.
   • This form must be completed within 60 days of the date of the high consumption.
   • All customers requesting a leak adjustment are required to pay their bill in full or make payment arrangements while this form is being processed.
   • The customer is responsible for all water that passes through the meter. Adjustments will be made to the rate applied to the unexpected water loss based on the customer’s 12-month average water rate prior to the leak.
   • The customer must submit a copy of the repair invoice/payment receipt from the company performing the work. This should include the address, date, and nature of the work. If self-repaired, the customer must provide a brief written explanation of the repairs performed along with copies of invoice/receipt for repair parts
   • Once this form is received, the customer will be notified within 60 days of the adjusted amount.
4. Name*
5. Utility Account Number
7. Service Address*
8. Phone Number*
10. Email*
11. Date you first noticed leak*
    Date you first noticed leak
13. Date the leak was repaired*
    Date the leak was repaired
14. Location of the leak (outside/inside)*
16. Please describe the specific nature of the leak; i.e., leaky toilet, broken sprinkler line, etc.*
18. Briefly describe the repairs that were made*
20. Receipts/Invoices
22. Today's Date*
    Today's Date
Leave This Blank:


24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

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