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2. 
3. Coachella Valley Water District
   Request for Account Review (WS-99)
   
   
   
   
   
   

5. Please read and complete the information below to request a review of your account for excessive water consumption.

   Coachella Valley Water District charges for all water that passes through a customer’s water meter.  If an adjustment is granted, all consumption above the historical amount will be rebilled at the Tier 2 base rate.

7. I certify that all conditions below have been met. I understand that if they are not, my request will be denied.
9. 1. I took action within thirty (30) days from the first notification to fix excessive water use.
11. 1. This request is being submitted within sixty (60) days of my initial bill reflecting the high consumption.
13. 1. I have received my bill reflecting high water consumption. (If not, please submit this request after the bill is received.)
15. 1. Excessive consumption was not caused by overseeding, refilling a pool, a running water hose, a malfunctioning irrigation timer, etc.
17. 1. I understand that before any adjustment is granted, consumption must have returned to normal use.
19. 1. I understand that all consumption above historical consumption for the month(s) I am requesting will be recalculated at the Tier 2 base rate.
21. 1. I understand that I am required to make on time payments to avoid discontinuance of service, late fees and delinquency charges while my account is under review.
23. 1. I understand that the account review process may take up to four (4) weeks.
25. Account Number - First 6 Digits*
26. Account Number - Second 6 Digits*
28. First Name*
29. Last Name*
31. Service Address Line 1*
33. Service Address Line 2
35. City*
    -- Select One --Cathedral CityDesert Hot SpringsIndian WellsIndioLa QuintaMeccaNilandPalm DesertRancho MirageSalton CitySky ValleyThermalThousand Palms
36. Zip Code*
38. Primary Telephone Number*
39. Primary Telephone Number*

    1. Cell Phone
    2. Home
    3. Work
41. Secondary Telephone Number
42. Secondary Telephone Number Type

    1. Cell Phone
    2. Home
    3. Work
44. Email Address*
46. I am submitting this request on behalf of a Homeowner's Association or Property Management Company.*

    1. Yes
    2. No
47. My role with the Homeowner's Association or Property Management Company*
49. Homeowner's Association or Property Management Company Name*
50. Homeowner's Association or Property Management Company Primary Telephone Number*
52. Please choose only one from the selection below:*

    1. Courtesy Adjustment for a Water Leak
       
       Limited to one (1) adjustment in a rolling twelve (12) month period. Proof of Repair is required, which must include dated receipts and/or photos.

    1. Courtesy Adjustment for Unexplained Water Loss
       
       Limited to one (1) adjustment in a rolling five (5) year period.
54. Upload receipts or photos*
55. Upload receipts or photos
56. Upload receipts or photos
58. The leak was discovered on or about:*
    The leak was discovered on or about:
59. The water leak was repaired on or about:*
    The water leak was repaired on or about:
61. High consumption was reflected on the following months' bills: (choose one or two months)*
    -- Select One --January FebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember
62. Second month:
    
    
    -- Select One --JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember
64. Please provide justification for adjustment or additional comments.*

66. Terms & Conditions

    Coachella Valley Water District (CVWD) Domestic Water Rules and Regulations:

    §3.05.280(D)(5) - Adjustment of Bills for Excessive Consumption: It is the customer’s responsibility to properly maintain the property’s private plumbing water system, including irrigation systems and water features. A leak in the customer’s water system is the sole responsibility of the customer and the district charges for all water that records and passes through the water meter. If a customer requests the district to review a bill for water service due to excessive consumption, the district may grant an adjustment subject to the conditions below.

    a. Verified Adjustments i. Verified adjustments for high consumption may be granted to customers when there is explained high consumption such as a water leak on the customer’s property. The district, after investigation, shall find all of the following: (A) The meter must be re-read, may be field tested, and verified as accurate.  (B) The customer made the request for billing review within 60 days of the first bill date reflecting excessive consumption. (C) Upon notification of excessive water consumption, the customer took prompt action to locate the leak and complete repairs within 30 days. Notification to the customer may take the form of a billing statement, written communication to the customer, a courtesy phone call or a notice left at the property. (D) Proof of repair, including copies of repair bills or photographs, is required. (E) The customer did not have a verified adjustment in the previous 12-month period prior to the bill with excessive consumption. ii. All consumption above historical consumption for that month will be recalculated at the Tier 2 base rate. iii. No adjustment shall be made for any period longer than 60 days or for water delivered 30 days after the district notifies the customer of the excessive use. iv. Consumption must have returned to historical use. v. No more than one verified adjustment shall be made for excessive consumption within a rolling 12-month period.

    b. Unverified Adjustments i. Unverified adjustments for high consumption may be granted to customers when there is unexplained high consumption on the customer’s property. The district, after investigation, shall find all of the following: (A) The meter must be re-read, may be field tested, and verified as accurate. (B) The customer made the request for billing review within 60 days of the first bill date reflecting excessive consumption.  (C) Upon notification of excessive water consumption, the customer took prompt action to locate the possible cause of the excessive consumption within 30 days. Notification to the customer may take the form of a billing statement, written communication to the customer, a courtesy phone call or a notice left at the property. (D) The customer did not have an unverified adjustment in the previous five-year period or a verified adjustment in the previous 12 months prior to the current bill with excessive consumption. ii. All consumption above historical consumption for that month will be recalculated at the Tier 2 base rate. iii. No adjustment shall be made for any period longer than 60 days. iv. Consumption must have returned to historical use. v. No more than one unverified adjustment shall be made for excessive consumption within a rolling five-year period. (Ord. 1399.15 2022)

68. By typing or signing my name, I certify that I understand the terms and conditions outlined above and that to the best of my knowledge the information I provided is true and correct.*

70. COACHELLA VALLEY WATER DISTRICT
    Post Office Box 1058
    Coachella, California 92236
    (760) 391-9600
    (760) 398-3190 - fax
    CustomerService@cvwd.org

    rev 5/2023

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71. 1. Receive an email copy of this form.
72. Email address

    This field is not part of the form submission.

73. Submit

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