Leak Allowance Form

Please note fields with an asterisk * are mandatory.

Account Details

Contact Person Name *

Address Line 1 *

Address Line 2 *

City

County *

Contact Person Phone Number *

Contact Person Email Address

Meter Details

Meter Number

Opening Hours

Is there any restriction/obstruction to accessing the meter?

Yes

When did the leak start approximately?

When was the leak repaired? *

Meter Reading 1 *

Date of Meter Reading 1 *

Meter Reading 2 *

Date of Meter Reading 2 *

Are you providing a Plumbers Report or was this Self Fix? *

Plumbers Report

Self Fix

Please upload Plumbers Report *

*Files must be a PDF, PNG or JPG and the max size is 15MB.

Please note that only 1 Self Fix allowed per account

Please provide any additional commentary: