Customers requesting a leak adjustment must complete this form. Adjustments are not given for fixtures left running or the resetting of irrigation timers. Eligibility requirements below.

• One leak adjustment permitted per 36-month period
• Water bill must exceed $200.00
• Partial payment of at least 50% of the original bill amount required
• Repair (absence of leak) must be verified by District prior to submission
• Receipts (for parts and/or services) showing proof of repair must be submitted with request