Union Hill Water Association

Application for Leak Adjustment Credit


Name:  ______________________________________________    Date: _____________  

Service Address:__________________________________________________________  

Mailing Address:__________________________________________________________  

Phone Number: __________________________  

The Union Hill Water Association’s leak credit policy is as follows:  

It is the member’s responsibility to properly maintain his or her water system and any irrigation sprinkler system connected to such system. The member’s water system includes all water and related facilities and appurtenances on the member’s side of the water meter. This responsibility includes the responsibility to promptly discover and repair leaks in the member’s water system and to limit the amount of water loss through a leak.  A leak in the members’ water system is the sole responsibility of the member.  

The Association may, in its sole discretion, grant a credit to a customer’s water bill for a leak in the member’s water system under the following conditions:  

·            The leak has been repaired. Proof of repair to the Association’s satisfaction will be required by the Association before a credit is granted.   Proof of repair, i.e. receipts for any parts or services purchased, must be submitted with this form.

·            The customer is not in violation of any Association policies and is otherwise current in the member’s obligations to the Association.

·            A credit may only be applied to to a maximum of two consecutive billing cycle.  If a leak occurs over more than two different billing cycles, the credit will be applied to the two billing cycle with the most usage. 

·            Once a member receives a credit, the member may not be granted another credit for ten years.

·            If granted, the amount of any credit will be computed as follows and in accordance with the attached worksheet.  

By signing this request,  I certify that I understand the terms and conditions of the Association’s Leak adjustment Policy and acknowledge that I will not be eligible for an additional Leak Adjustment for ten years.  

___________________________________           _____________________

Customer Signature                                                  Date