Leak Adjustment Form – Consolidated Utility District of Rutherford County

NOTE: This form will not be accepted without receipts and/or photos.

Cycle Number

Customer Number*

Account Number*

Email*

Street Address*

Owner*

Tenant

Date of Repair*

This is to certify that the plumbing at the above address has been repaired and is now free of leaks. These leaks were large enough to cause an increase in the water bill.

The repairs were made as follows:*

Please upload any receipts or photos. Files must be smaller than 10 MB.*

Max. file size: 2 MB.

Additional Files

Max. file size: 300 MB.

Additional Files

Max. file size: 300 MB.

By checking "Yes" I make the oath that the above is true in fact & substance.*

Yes

Any customer is eligible for a water leak adjustment if:

The water usage is twice the normal monthly average.

The house and/or service line is over (1) year old.

The customer has not had an adjustment at the above address in the past (12) months.

The adjustment will be made after the water usage returns to normal. Only the (2) highest bills will be adjusted. The customer must go one full billing period with no leak before an adjustment is made. At that time the lost water will be calculated at the current reduced rate.

All Leak Adjustment forms must be submitted within 90 days of the repair to be considered for an adjustment.

CUD has attempted to notify a customer of a 24 hour continuous flow and if the continous flow has continued for a period of three months without the customer having repaired and documented the repair, then the customer will not be eligible for any leak adjustment as provided by this policy regardless of the cause or circumstance.

Adjustments for irrigation leaks, unexplained usage, swimming pool leaks or water softener leaks may be adjusted by CUD one time within a five year period with proper documentation meeting the criteria within this policy. Adjustments will not be given for filling a swimming pool.