Harris County Municipal Utility District No. 365 (the “District”) will consider permitting a leak adjustment credit because of loss of water through an “excusable defect” in the customer’s water line. An excusable defect means a rupture in or leak from the customer’s water lines caused by freezing weather, settlement, corrosion, wear, or accident. Visible leaks such as faucet and hose leaks are ineligible. Leaks internal to the structure on the property are ineligible. Credit may be given for one-half of the District’s rate charged to usage in excess of the average use during the period of the year in question, as determined by the District (the “Leak Adjustment Credit”). Credits are only available for a customer with at least one year of usage history in his or her name at the service address given above. No credit will be given for North Harris County Regional Water Authority pumpage fees. The Leak Adjustment Credit is limited to a maximum of three (3) consecutive months and must be requested within six (6) months of the repair. Customers may apply for no more than two (2) leak adjustments in any twelve (12) month period.
Your Name:
Your Account Number:
Service Address:
Daytime Phone Number:
Date Leak Started:
Date Leak Was Repaired:
During this period, the following additional water appliances (washer, dishwasher, spa, etc.) were installed at the service address. State “NONE” if none were added.
IN ORDER TO PROCESS YOUR APPLICATION QUICKLY AND EFFICIENTLY, PLEASE READ THE FOLLOWING CAREFULLY AND GIVE A CLEAR DESCRIPTION OF THE REPAIRS.
Type of Leak on Customer’s Side of the Meter:
Description of Repair:
Attach the bill or bills for which adjustment is being sought and documentation of the repair date, address, type of repair, and cost.Acceptable documents include plumber’s statement/bill or a receipt for parts. Businesses with in-house maintenance may submit a statement signed by two (2) employees who witnessed the repair. In all cases, the District retains the right to make field verifications before approving leak adjustments. You will be notified by mail generally within 90 days whether your request is approved or denied.
File Upload (.jpg or .pdf format; size limit: 2MB)
I am the Responsible Party for the account at the above service address. I am asking the District to reduce the water bills for this account, to the extent allowed by the District’s policy because of a leak related to the above dates. I am familiar with all of the facts stated in this document and they are true and correct. I certify that this application and attached documents contain no false statements.
Date:
