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Water Waste Reporting Form

2. This Form helps us identify water waste that is occurring in our service area.
   For major water leaks that require urgent attention, please call us immediately at (510) 668-6500.
4. For information on State Regulations pertaining to water waste please visit:
   http://www.waterboards.ca.gov
6. Contact Information
   You can report this information anonymously, but please provide enough information so that we can determine the appropriate action.
8. Your First Name (optional)
9. Your Last Name (optional)
11. Your Phone Number (optional)
    So we can follow up with questions to help identify the issue, if needed.
12. Your Email Address (optional)
    So we can follow up with questions to help identify the issue, if needed.
14. Address of Water Waste*
    Provide the address or cross streets/location where the waste is occurring.
16. City
    -- Select One --FremontNewarkUnion City

    Must be in Fremont, Newark or Union City
18. Please check the appropriate box(es)*

    1. Using potable water to wash sidewalks & driveways
    2. Runoff when irrigating with potable water
    3. Using hoses with no shutoff nozzles to wash cars
    4. Using potable water in decorative water features that do not recirculate the water
    5. Other (explain below)
20. Description of the Issue*
    Include time of day information so we can observe the occurrence, if needed.
22. Additional Location Information (if necessary)
23. Upload a picture
    You can upload a photo so that we can get a better idea of what the issue is.
25. Upon receipt of this information we will investigate to determine the appropriate action.
    Thank you for your assistance!
Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field