Sebastopol, CA · Sonoma County
Utility Leak Adjustment Request
Sebastopol utility account holders use this form to request a water bill adjustment after repairing a leak and attach receipts documenting the repair.
What this form is
Use this form after a water leak has been repaired if you believe your account qualifies for a leak adjustment. The form asks for account and contact details, when the leak was discovered and repaired, and a description of the leak and repair. Attach copies of receipts for repair materials or services; the attached policy describes eligibility and how the city reviews requests.
Who needs it
A utility account holder who has repaired a leak and believes the account meets the attached policy’s conditions can submit this written request.
How to submit it
Mail or email the completed form and required repair receipts to the Utility Department at City Hall. The form lists 7120 Bodega Ave, Sebastopol, CA 95472, and [email protected].
About notarization
This request is signed and dated without a notary; the form requires repair receipts as attachments, but does not identify them as sworn or notarized.
How to submit this form
- 1
Download The Form
Download the Utility Leak Adjustment Request and read the attached leak credit policy.
- 2
Complete The Request
Enter the account and contact information, leak discovery and repair dates, and a description of the leak and repair.
- 3
Attach Repair Receipts
Include copies of receipts for materials or services related to the repair and briefly describe the attached receipts.
- 4
Submit To The City
Mail or email the completed request and receipts to the Utility Department at City Hall using the contact details on the form.
Frequently asked questions
- Do I need a notary for the Utility Leak Adjustment Request?
- No. The account holder signs and dates the request without a notary. Attach copies of receipts for repair materials or services; the form does not require notarized receipts.
- How do I submit the Utility Leak Adjustment Request?
- Mail or email the completed form and copies of repair receipts to the Utility Department at City Hall. The form lists 7120 Bodega Ave, Sebastopol, CA 95472, and [email protected].
- What should I include with the request?
- Complete the customer and leak repair information, describe the leak and repair, and attach copies of receipts for materials or services related to the repair.
- Does submitting the form guarantee a bill adjustment?
- No. The form says completing it does not guarantee an adjustment. City staff review water-use history, and adjustments are subject to the attached policy.