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Leak Adjustment Request

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I hereby notify Mount Pleasant Waterworks that I have sustained a water leak at the above address and that it has been repaired. I am requesting an adjustment to my bill per Mount Pleasant Waterworks policy. I understand that signing this form does not guarantee a billing adjustment will be granted. I am providing a copy of the paid repair bill and/or material receipts. I also understand that failure to provide proper documentation may result in a denial of this leak adjustment request. If approved, Mount Pleasant Waterworks will adjust up to three billing cycles if applicable. I understand that by accepting any adjustment offer made by Mount Pleasant Waterworks I am utilizing my one leak adjustment per 12- month period per account. MPW will complete review and notify customer of decision within 10 business days.

I understand this form does not relieve my responsibility of payment.



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