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Leak Adjustment Request Form

  1. CWD Logo 3C 2017_100x100
  2. 18631 SE 300th Place Covington, WA 98042 Phone: 253-631-0565 Fax: 253-867-0878
  3. LEAK ADJUSTMENT REQUEST FORM
  4. Since our community’s groundwater supply is limited and using it efficiently is of prime importance, the District urges customers to repair all leaks promptly. To support our customers in this endeavor, the District offers one leak adjustment, every eight years during the term of home ownership. Customers pay their average consumption plus 50% of the remaining leak consumption. Average consumption is based on the actual consumption for the same period in the previous two years. Leak adjustments may only cover two consecutive billing periods. Please provide the information requested below and return this form to the District. You will be notified regarding the outcome of your request. If you have any questions, please contact Customer Service at (253) 631-0565 during regular business hours.
  5. Process AUTO PAY?*
    CWD will make every attempt to stop auto pay for large balances; however, it is the customer’s responsibility to notify CWD immediately after billing that AUTO PAY should be suspended.
  6. A copy of the repair invoices or store receipts for parts used in the repair must be attached in order for the request to be processed.
  7. I hereby notify the Covington Water District that I have sustained a water leak at the above address and that it has been repaired. I am requesting an adjustment to my utility bill per District policy. I acknowledge that signing this form does not guarantee a billing adjustment will be granted and that if I am authorized to receive an adjustment only one leak adjustment will be allowed for my account in any 8 year period.
  8. I have checked my low flow indicator for movement and confirm no movement was detected.

  9. Property Owner Signature*
  10. Leave This Blank:

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