FORMS

Application for Leak Billing Adjustment

DOUGLASVILLE-DOUGLAS COUNTY WATER AND SEWER AUTHORITY

Overview of Leak Billing Adjustments

The Douglasville – Douglas County Water and Sewer Authority (the “Authority”) is committed to promoting water conservation and reducing water loss through timely leak repair. The Authority is responsible for providing water up to and through an Authority-owned meter, and the customer is responsible for maintaining the private service line and plumbing facilities on the customer’s side of the meter, including any water lost due to leaks or breakage on the customer’s side of the meter.

Eligibility Requirements for Leak Billing Adjustments

As a courtesy to customers who meet all the below requirements, the Authority may review the customer’s account for a leak billing adjustment when a qualifying leak occurs on the customer’s side of the meter, in accordance with the Authority’s Rules and Regulations.
1. The qualifying leak was detected and reported to or by the Authority within thirty (30) days.
2. An Application for Leak Billing Adjustment (“Application”) was submitted to the Authority within two (2) months of the completed repair of the leak at issue.
3. Leak billing adjustments for sanitary sewer will be considered only when it is shown, to the satisfaction of the Authority, that the water did not enter the sanitary sewer system.
4. Before any Application will be processed, customer consumption must return to normal average usage for the premises, indicating that any issue giving rise to this Application has been resolved.
5. The customer must maintain full payment of all amounts due or enter into and comply with an approved payment arrangement, until the Application is approved or denied.
6. The customer must meet program limits, including no more than one (1) leak billing adjustment within any twelve (12) month period, and any approved adjustment shall apply to no more than three (3) consecutive billing cycles affected by any issue giving rise to this Application.
7. The customer must provide proof, to the satisfaction of the Authority, that a completed repair has resolved any issue giving rise to this Application, including plumber invoices or receipts for any supplies purchased relevant to the repair, and a letter describing any self-performed repairs along with the repair date.

APPLICATION FOR LEAK BILLING ADJUSTMENT

Please review the above eligibility requirements before submitting this application.

Customer Detailed Email

Customer Information

Customer Name

First

Middle

Last

Customer Account Number

Phone Number

Email Address

Repair Completion Date

Location of Leak/Breakage (Select One)

House
Yard
Other

Detailed Description of Leak/Breakage

Service Address

Address Line 1

City

State

Zip Code

Application for Leak Billing Adjustment: As a courtesy to me, I hereby request that the Authority review my account for a leak billing adjustment. As used in this Application, “I,” “me,” and “my” mean the customer of record signing this form for the Authority account identified above. By signing below, I understand and acknowledge that any adjustment approved will be made in accordance with the Authority’s Rules and Regulations and applicable policies as stated herein. I further understand and acknowledge that I must cooperate fully with the Authority in its review of my application, that I am required to meet all the eligibility requirements above, and that any documentation I provide must be determined satisfactory by the Authority. I also understand and acknowledge that completion of this Application and submission of all requested documentation does not guarantee approval of a leak billing adjustment. If approved, any adjustment will be applied as a credit to my account only and will not be paid as a refund. My Application will be considered only upon the Authority’s receipt of all documentation required and/or requested for supplementation by the Authority, and any account balance remaining unpaid by the due date will subject my account to late penalties and/or termination of service regardless of the status of my Application. I agree that this Application may be stored electronically and any electronic copy, including the signatures thereto, will be deemed an original, admissible, and enforceable to the same extent as a paper original.

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Application for Leak Billing Adjustment

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Overview of Leak Billing Adjustments

Eligibility Requirements for Leak Billing Adjustments

APPLICATION FOR LEAK BILLING ADJUSTMENT