Request for Leak Adjustment Customer Name (as appears on bill) *Today's Date *Service Address *Account NumberEmail Address *Phone Number ***PLEASE CLICK BELOW TO READ OUR LEAK ADJUSTMENT POLICY.** Leak Adjustment PolicyLocation of Leak (toilet, underground, etc.) *My leak was fixed on: *Your leak must be fixed in order for us to adjust your bill.Do you have an irrigation system? *YesNoRepair ReceiptsDrag and Drop (or) Choose FilesReceipts for payments for parts/repairsContractor InvoicesDrag and Drop (or) Choose FilesPhoto Evidence of RepairDrag and Drop (or) Choose FilesIf you have any trouble uploading attachments above, you can email them to customerservice@lcwsa.com.I understand that in order to qualify for a leak adjustment, the customer should have lived at the current address for at least 6 months. If the customer does not have 6 months of regular bills yet at that address, the customer can wait to fill out the leak adjustment form after being billed 6 times (excluding the bill the customer would like adjusted). I also understand the leak adjustment policy linked above. *I accept these terms.Submit
