Application for Pool Adjustment

Application for Pool Adjustment
Please complete this form in its entirety and allow 8 to 12 weeks for your account to be processed.

If printing and mailing, mail to:

Central Alabama Water

Customer Relations Department

P.O. Box 830110

Birmingham, AL 35283-0110

Please DO NOT mail with water and sewer bill.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Customer Account Number
Date(s) Pool Filled
Signature
Please do not submit this form if your pool is not registered in the CAW pool database. You may call the office at 205.244.4000 for assistance.

3600 First Avenue North, P.O. Box 830110, Birmingham, AL 35283-0110 / Phone (205)244-4000 / Website www.caw-al.gov
DO NOT WRITE BELOW THIS LINE - FOR OFFICE USE ONLY

Enter values in Gal/HCF (hundred cubic feet)

Rows	Pool Capacity (Full)	Billed Consumption	Account Average
Gal/HCF