Fillable I aAunited Non return to sewer claim form (United Utilities)

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I aAunited Non return to sewer claim form (United Utilities)

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The I aAunited Non return to sewer claim form (United Utilities) form is 2 pages long and contains:

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  • 4 check-boxes
  • 92 other fields

Country of origin: UK
File type: PDF

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I aAunited
\,:::, Utilities
Water for the North West
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Non return to sewer claim form
for domestic metered customers
The sewerage volumetric charge assumes that on average, 5 per cent of the metered water supplied to customers is not returned to a
public sewer. This applies to all domestic customers and is already reected in the sewerage charge. It covers things like evaporation
from cooking, cleaning, car washing, garden watering - basically any activity which results in some of the water supplied to your home
not returning to the public sewer.
If you have a metered water supply and can demonstrate that more than 5 per cent of the water supplied to your home through
your water meter is not returned to a public sewer on a regular basis, please complete this form and return it to
Customer Service Centre, PO Box 50, Warrington WA55 1AQ.
When we have received your application form, we will assess your claim and make a decision based on the details you have provided.
We will try to make a decision within 10 working days. We may need to visit your home to verify your claim. If this is necessary, we will
contact you to make an appointment, and the time to process your application will be longer.
Important - please read the notes at the bottom of page 2 before completing the form and ensure all sections are completed fully.
Customer account number
(shown on your water bill)
Section A Customer and property details
Title (please tick)
Mr Mrs Miss Ms Other (please state)
Full name
Full postal address of property
for which you are claiming an
allowance (including postcode)
Home telephone number
Work telephone number
Mobile telephone number
Email
Date of birth
D
D M M Y Y Y Y
Number of residents living in the property Adults Children
Water meter reading
Black digits only
Date of read D
D M M Y Y Y Y
Section B Claim details
Swimming pool and/or garden pond
Do you have a swimming pool or garden pond at your property?
Yes No
If YES, please tick relevant
categories
Outdoor swimming pool Indoor swimming pool
Permanent structure Temporary structure
The size of your swimming pool
or garden pond
Length (m) x Width (m) x Average depth (m) = Capacity (cubic metres)
Does the backwash discharge to the public sewer?
Yes No
Is the pool or pond ever drained?
Yes No
If YES,
how often?
When was the pool or pond
last drained?
D
D M M Y Y Y Y
Was it drained to the public sewer?
Yes No
If not, give full details
Is the pool or pond covered in
the winter months?
Yes No
If YES, how many months is it covered?
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Utilities
Water for the North West
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Automatic irrigation system
Do you use an automatic irrigation system on your garden?
Yes No
If YES, what is the total area of your garden in square metres (approximately)?
What is the area of the garden that is watered by the irrigation system (in square metres)?
How often is the irrigation
system used
(please ll in all parts)?
Minutes per application Times per day Days per year Flow rate
Livestock
Do you keep livestock, ie, horses, cattle, sheep?
Yes No
If YES
, give details, including
how many livestock you have
Other
Please give details of water
that for any other reason, is
not returned to the public
sewer. Please provide your
calculations.
Section C Your calculation
Estimate the annual volume
of mains water that is not
returned to the sewer. Give
your measurement in litres or
cubic metres, showing your
calculation in full.
Section D Declaration
I am claiming for a non return to sewer allowance in respect of the property detailed in Section A above. I declare to the best of my
knowledge and belief that the information provided is true and reasonable. I accept that this information may be subject to verication
by United Utilities before any allowance for non return to sewer is granted. I have read the supporting notes that are attached to this
application.
Signed
Dated D D M M Y Y Y Y
Additional information - Please read carefully before submitting a claim
Non-return to sewer claims:
We require a meter reading history of at least 12 months in order
It is your responsibility to demonstrate that signicantly less than
for a claim to be made. If this is not available, the claim will be
95% of the water we supply is returned to the public sewer
deferred until we have meter readings for a 12 month period.
Any agreement for a reduced return will be eective only from the
Where a large non-return volume is being claimed, we may ask
date of which the application was made and will not be backdated.
the customer to install a sub-meter on a branch pipe to record the
You must notify us immediately of any changes in water use that
volume.
can materially aect the allowance granted.
We may arrange to visit the property at any time to validate your
Any allowance applied is in relation to the property for which it
claim. If your claim is found to be inaccurate we will reclaim
has been agreed and will not be transferred should you move to
charges from you to the date of your original application.
another property within the United Utilities region.
About us
United Utilities is the North West s water company. We keep the taps owing and toilets
ushing for seven million customers every day. From Crewe to Carlisle, we work hard
behind the scenes to help your life ow smoothly.
United Utilities Water Limited, Haweswater House, Lingley Mere Business Park, Lingley Green Avenue, Warrington WA5 3LP.
Registered in England and Wales. Registered Number 2366678.
06/20/SD/8485-6597
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I aAunited Non return to sewer claim form (United Utilities)

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Completed 7 June 2021

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