Customer Water Leak Appeal and Adjustment Form

In the event of a private leak, OMWD may make adjustments to variable water charges for a billing period in which an apparent water loss occurred due to a broken pipe and/or plumbing fixture that caused exceptionally high water consumption compared to consumption history for the property during the same billing period.

To request an adjustment to your water account, please fill out the form below in its entirety.

* Required Field

Customer Name: * Required
Account #: * Required
Service Address: * Required
Preferred Phone #: * Required
Alt. Phone #:
Email: * Required

(Your email address will not be shared with any third parties.)
Alt. Email:
Date Leak Found: - must be mm/dd/yyyy format * Required
MM slash DD slash YYYY
Date Leak Repaired: - must be mm/dd/yyyy format * Required
MM slash DD slash YYYY
Proof of Repair (copies of receipts): * Required
Drop files here or

Accepted file types: doc, pdf, jpg, png, gif, Max. file size: 5 MB, Max. files: 2.
Maximum file size - 5 mega bytes.
Leak Details: * Required
(100 words or less)
Please review the following provisions set forth in Section 9.16 of OMWD’s Administrative and Ethics Code to which your request is subject.
1. The customer must not have received an adjustment at the same property under this policy in the past 60 months.
2. A leak appeal form must be properly completed by the customer and submitted with required documentation within 25 days of the statement date of an affected bill.
3. A maximum of two billing periods will be considered for an adjustment.
4. The value of the adjustment for domestic customers will be determined by applying the Tier 2 water rate to all usage during the affected billing period(s) that was charged at Tier 3 and Tier 4 rates. The value of the adjustment for all other customers will be determined by applying the domestic Tier 2 water rate to all usage above 25 units during the affected billing period(s). No adjustment shall exceed $750.
5. No adjustments will be given if OMWD determines excessive water flow was caused by the customer’s negligence or non-responsiveness to warning signals such as higher water and/or sewer bills, leak notifications, visible water, or other factors that should have made the customer reasonably aware of the existence of a broken pipe and/or plumbing fixture.
6. No adjustments will be given if a third party is responsible for water loss at the customer’s property and can be pursued for reimbursement by the customer.
7. No adjustments will be given due to the resetting of irrigation timers at the customer’s property, whether intentional or not.
8. OMWD is not responsible for any leak due to lack of notification and no adjustment will be given for this reason. It is the customer’s responsibility to determine leaks and/or excessive water use.
9. The General Manager is not obligated in his/her sole discretion to grant any adjustment.
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Customer Water Leak Appeal and Adjustment Form

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