Skip to Main Content
Do Not Show Again
How Do I...
Select a Category
Customer Service Forms
signing in or creating an account
, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.
Leak Adjustment Request Form
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
No more than one adjustment will be made on an account within a 12-month period.
Name on Water Account
Please enter the name on the BWA water account for which you are requesting an adjustment.
BWA Account Number
Enter the BWA Account Number
Enter the service address associated with this account.
Date(s) of Leak
Enter the date or range of dates for the high water bill.
Enter the date of and a description of the repair.
Upload a copy of the paid plumber's invoice. If you made the repairs yourself, please upload a copy of the receipt for parts purchased for the repair.
Leave This Blank:
Receive an email copy of this form.
This field is not part of the form submission.
Submit and Print
* indicates a required field
Slideshow Left Arrow
Slideshow Right Arrow