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Water Complaint Form

Complaint Information

The Complaint Form information is essential for us to investigate your complaint. Please fill out all the required fields, denoted below with an * and provide us with as much detail as possible.

Account Holder's Name

*First Name:

*Last Name:

Alternate Contact * Alternate Contact Required if different from Account Holder

First Name:

Last Name:

Relationship to Account Holder:

*Email:

Please enter only one email address.

Service Address

Business:

*Address 1:

Address 2:

*City:

*State:

*Zip Code:

County

Mailing Address

*Mailing Address required if different from Service Address.

Business:

Address 1:

Address 2:

City:

State:

Zip Code:

Contact Numbers

* Day:

Evening:

Complaint Information

* Name of Company that the Complaint is Against:

*Account Number:

Complaint Reason:

Complaint Reason

*Description of complaint (limited to 2500 characters)

THIS IS REQUIRED: Enter a brief summary of your complaint. This text can be up to 2500 characters. When you have completed your summary, scroll down to the upload section below which will allow you to upload any attachments along with your complaint.

You have 2500 characters remaining for your summary...

File Upload

This section is optional

You can upload multiple files to be attached to your complaint. There is a maximum size 20 mb for the total number files. For example, you can have one file that is 20 mb or 4 files that are 5 mb each.

Relevant documents would be any documentation that supports the complaint, including copies of bills or terms of service documents. PDF files are preferred, but we will also accept .JPG and .TXT files.

Maximum file size allowed is 20MB.

File types allowed are .JPG, .TXT, .PDF.