Non-Emergency Service Request Form

First Name

Last Name

Phone

Address

Account Number

Nature of Concern

Water leak / broken water line (for a public line - not on the home/business side of the meter) Low water pressure No water Wastewater overflow / sewer backup Meter issue / meter reading Unauthorized water use Stormwater drainage (not related to roadside ditch) Other (please specify)

If Other

Description / Details (Enter a brief but clear description of the problem: when it began, frequency, other observations (e.g. odor, discoloration), etc.)

Upload Photo(s) Attach one or more images illustrating the issue (jpg, png, pdf, up to e.g. 10 MB).

Location Details (if precise address not known) Nearest intersection; Side of street (N, S, E, W); Nearby landmark; GPS coordinates (optional)

Preferred Contact Method

Email Phone No preference

If you have already reported this to another agency, provide the following details: Date reported, Which agency, Reference or ticket number, Contact name

Consent and Disclaimer

I understand that submitting this does not guarantee immediate resolution, but it will be logged and assigned for response.

After You Submit

You will receive an acknowledgment (via email or phone) with a reference or ticket number.
WWA will review your request. If the issue falls under the jurisdiction of The Township or Precinct 3, we will notify you of the appropriate entity to contact.
REMINDER: DO NOT USE THIS FORM TO REPORT AN EMERGENCY. For emergencies (e.g. major leaks on the public side or wastewater backups), please call 281-537-4376.