Pool Fill JAN23 2026

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The document is a Pool Fill Credit Request Form for customers seeking a sewer adjustment due to filling a swimming pool. It outlines the eligibility criteria, including the need to submit the request within 30 business days and limitations on adjustments. The form requires customer details, pool dimensions, and contractor information.

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Click ‘Get Form’ to open the Pool Fill JAN23 document in the editor.
Begin by filling in the 'Cycle/route' and 'Last pool fill' fields at the top of the form. These details help track your request.
Enter the 'Received date' and 'Processed date' as required. This information is crucial for processing your adjustment request.
In the customer information section, provide your name, service address, customer number, account number, phone number, and email address.
Specify the pool size in gallons and fill date. Additionally, include dimensions such as length and width, along with selecting the pool shape from the options provided.
Complete the depth measurements for both shallow and deep ends of your pool.
Finally, have your pool contractor sign off on the form before submitting it for processing.

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