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LOS ANGELES COUNTY WATERWORKS DISTRICTS
CUSTOMER REQUEST FORM

LA County Waterworks Districts
Please complete the form within one hour. This application will not save any information until you click the Submit button at the end of the form. For your convenience, a count-down timer is displayed on the page. Refreshing the page will restart the timer but all information will be lost.
* indicates Required fields
Customer Information
First Name*:  
Last Name*:  
Service Address*:
Contact Phone Number*:
 
Account #
(if available)
 
Customer #:
(if available)
 
Email address*:  
Request Type*:  
 

Attachments:*

Comments:







To process your request, please attach required documentation:
Start/Transfer Water Service:
Request Refund:
Declaration of Household Income:
Water Bill Appeal:
Change of Billing Address:
Downsize your Water Meter:
Change to an Existing Water Service including Upgrade or Relocation/Fire Flow Availability Request:
Temporary Construction Water from Hydrant:
Fire Sprinkler Design Information Request
Inspection








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