Application for Water Leak Adjustment

Customer Name (required)

Account Number (required)

Service Address (required)

Phone Number (required)

Email (required)

Dates of Service/Month of Water Leak (required)

Problem Description: (required)

Was the leak underground? (required)

YES

NO

Was the leak through a: (required)

If your leak was something other than the check boxes above, please explain:

Date of repair: (required)

How was the leak discovered? (required)

Date of discovery: (required)

Please complete the following requirements, as an adjustment will not be applied to the account without them. (required)

Pictures of work completed.

Invoice/ Bills/ Receipts

Email to/from maintenance, landscaper, sprinkler, property managers, person(s) providing the repair

Signed up to receive emergency notifications through our Everbridge Notification System.

Signed Up with Eye On Water to monitor water usage

Signed up for Leak Alerts with Eye On Water

Supporting Documentation (required)