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Leak Adjustment Request Form

  1. No more than one adjustment will be made on an account within a 12-month period.

  2. Please enter the name on the BWA water account for which you are requesting an adjustment.

  3. Enter the BWA Account Number

  4. Enter the service address associated with this account.

  5. Enter the date or range of dates for the high water bill.

  6. 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.

  7. Leave This Blank:

  8. This field is not part of the form submission.