Eureka, CA · Humboldt County
Water/Sewer Leak Adjustment Request
This request lets an account holder ask the city for a water or sewer bill adjustment after a leak is fixed.
What this form is
Use this request to ask for an adjustment on the account at the address where a water or sewer leak occurred. It asks for the requester’s name, service address, leak and repair dates, who fixed the leak, and a brief explanation. If a plumber repaired the leak, the form asks for a copy of the plumber’s receipt.
Who needs it
An account holder seeking a leak adjustment can complete this request after the leak has been fixed.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This request is signed and dated without a notary; if a plumber repaired the leak, attach a copy of the plumber’s receipt.
How to submit this form
- 1
Download The Request
Download the Water/Sewer Leak Adjustment Request.
- 2
Complete The Form
Enter your name, the account address, leak and repair dates, who fixed the leak, and a brief explanation.
- 3
Gather The Receipt
If a plumber repaired the leak, attach a copy of the plumber’s receipt.
- 4
Submit The Request
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the Water/Sewer Leak Adjustment Request?
- No. The request is signed and dated without a notary. If a plumber repaired the leak, attach a copy of the plumber’s receipt.
- How do I submit the Water/Sewer Leak Adjustment Request?
- Submit it to the city department named on the form; check the city website for current contact details.
- What information does the request ask for?
- It asks for your name, the account address, when the leak was located and fixed, who fixed it, and a brief explanation of the leak.
- Do I need to attach a receipt?
- Attach a copy of the plumber’s receipt if a plumber repaired the leak.