843-681-5525

Leak Adjustment

Customer's Name As Listed on the Account*
First Last
Phone*
Email*
Service Address*
Street Address Address Line 2 City State ZIP Code
Date(s) of Bill(s) containing water volumes associated with the leak*
Leak Repair Date*
Date Format: MM slash DD slash YYYY
What was the source of the leak?*
What has been done?
As a Customer for the above listed service address, I hereby apply for a billing adjustment under the Hilton Head PSD Water Leak Adjustment Program. I confirm that the above and any attached information is true and accurate. I acknowledge and understand that only two water leak adjustment may be applied to my utility account in any 48-month period. I also acknowledge and understand that the PSD is not responsible for monitoring customer usage, notifying customers of leaks, locating leaks, or repairing leaks on the customer side of the meter and that the leak adjustment requested will reduce my excess usage for the allowable period to the lowest billing tier but will not eliminate usage charges for excess water consumed.
Attach a copy of invoices, receipts, other documents concerning repairs. File type supported: jpeg, pdf, gif, png.
Drop files here or

Accepted file types: jpg, pdf, gif, png.
I state the repairs have been completed.
Check the box below as an affirmation that repairs have been completed for residential customers and non-residential customers receiving an average of less than 300,000 gallons of water per month
- Affirmation of repair
Previous Water Leak Adjustment Request*
Has a water leak adjustment been requested or made for this service address during the last four years? Note: We can complete two adjustments every four years for a premise and leak adjustments will cover no more than two consecutive months.
- Yes
- No
When was the lead adjustment requested?
Date Format: MM slash DD slash YYYY
If this is a residential property, how many people reside at this address?
Was the premises vacant or unoccupied when the leak occurred?*
- Yes
- No
Please provide the period of time of the vacancy:
Customer Confirmation*
As a Customer for the above listed service address, I hereby apply for a billing adjustment under the Hilton Head PSD Water Leak Adjustment Program. I confirm that the above and any attached information is true and accurate. I acknowledge and understand that only two water leak adjustment may be applied to my utility account in any 48-month period. I also acknowledge and understand that the PSD is not responsible for monitoring customer usage, notifying customers of leaks, locating leaks, or repairing leaks on the customer side of the meter and that the leak adjustment requested will reduce my excess usage for the allowable period to the lowest billing tier but will not eliminate usage charges for excess water consumed.
I accept.
Phone
This field is for validation purposes and should be left unchanged.

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PSD Water Quality Laboratory recognized as Laboratory of Excellence

Hilton Head Public Service District’s (PSD) Water Quality Laboratory has once again been recognized as a Laboratory of Excellence as part of its annual certification

October 30, 2020

843-681-5525

Leak Adjustment

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PSD Water Quality Laboratory recognized as Laboratory of Excellence

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