Otay Water District | Leak Adjustment Request Form

Customer Information

Customer Name*

First Last

Account Number

Service Address*

Street Address Address Line 2 City State ZIP Code

Email Address*

Enter Email Confirm Email

Phone Number*

Brief Explanation of Leak*

Date of Incident*

Was there more than one incident?

Yes

Date of Second Incident

Date of Repair*

Was there more than one repair?

Yes

Date of Second Repair

Proof of Repair*

Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 8 MB.

You must submit proof of repair (such as a plumber’s bill, receipt for parts and/or photos) for the adjustment request to be considered.

If approved the adjustment will be made after the water usage returns to normal. The customer must go one full billing period with no leak before an adjustment is made. At that time the lost water will be re-calculated at the current lowest rate.

Customer Acknowledgment and Agreement*

I hereby acknowledge the information submitted is true. I also understand submission of this form does not guarantee adjustment issuance.