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2. 
4. Information and Instructions
   To request an appeal on your sewer charges due to anomalies resulting from irrigation leaks or pool fill-ups, please complete and submit this application within 90 days of the date on the bill reflecting the anomaly. The application and supporting documentation should be emailed to: wastewater@sahuaritaaz.gov or deliver/mail to: Sahuarita Wastewater Utility, 375 West Sahuarita Center Way , Sahuarita, AZ 85629. Applications will be reviewed within ten business days, at which time you will be notified of the result of the review.
6. The following criteria are required to be eligible for a billing adjustment:
8. *Only one adjustment is allowed per account within the last 12 months.
10. *Account must be current and in good standing (i.e., no past due balances).
12. *Only the account holder can request an adjustment.
14. *The high volume usage must be at least 1.5 times the prior twelve month average.
16. *For irrigation leaks, proof that the leak has been repaired must be provided.
18. Date of Application Submittal*
    Date of Application Submittal
19. Account #:*
21. First Name
22. Last Name
24. Address where leak occurred*
26. Billing Address (if different)
28. City
    Billing Address
29. State
    Billing Address
30. Zip
    Billing Address
32. Phone Number
33. Email Address:
35. Reason for Appeal / Description of Leak Repair*
    If more space is needed, please upload information as a supporting document.
37. Supporting Document #1
    Include receipts, photos, or other documentation supporting your appeal.
39. Supporting Document #2
    Include receipts, photos, or other documentation supporting your appeal.
41. Supporting Document #3
    Include receipts, photos, or other documentation supporting your appeal.
Leave This Blank:


43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit Submit and Print

* indicates a required field