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Customer Services

Business With PCWA


Treated Water Leak

Water Efficiency Rebate Form

Contact Information

Rebate Information

Please provide us the following information relating to your treated leak and leak fix. We would like to know approximately when the leak started, when you identified the leak, and when the leak was fixed. Additionally, we would like a brief description of the leak and the summary for the repairs that were made to fix the leak.

Rebate Eligibility Requirements

You must acknowledge the following requirements

Provide Attachments

Note - Image file formats are preferred (eg. JPG, PNG) for uploads. PDF files and Word Documents can be uploaded too but they must be less than 4 MB in size. If you are unable to attach the correct file type, or if any other issues with the attachments arise, you may select the box below and submit the files in an email.
Attach Receipt(s)

Attach Water Leak Photo(s)

Attach Repaired Leak Photo(s)

Acknowledge Terms & Conditions

I have read, understand, and agree to the Placer County Water Agency Treated Water Leak Rebate Terms and Conditions.

I understand that PCWA reserves the right to have an Agency representative verify the installation of the product(s) at the service address on the application.

Release of Liability & Signature

Placer County Water Agency (PCWA) reserves the right to deny an application of any participant who does not meet all requirements as outlined. PCWA reserves the right to change the terms of this program at their discretion. PCWA cannot guarantee that the installation of the product(s) will result in lower water utility costs. The number of rebates is dependent upon the availability of program funds. Applications will be processed when all required information is provided by the applicant on a first-come, first-served basis.

You must sign this form by typing your name

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