Name:

E-mail address:

Daytime phone number:

Location of the leak: (example: 107 Broadway, corner of Ash and Garth, etc.)

Briefly describe the problem: (example: water is pooling up near the meter, in the yard, on the street, etc.)

If you have problems with this form, you can call 874-7325 during business hours or send an e-mail to wlmail@GoColumbiaMo.com.