No credit for pool filling will be given without filling out this form completely and authorized by Jefferson Utilities, Inc
Gallons of water that the pool holds:
Was the pool completely empty when filled?
Type of Pool:
How is pool drained?
Please Specify Dimension:
To calculate gallons by dimensions give above: (3.14)(a)(a)(7.5)(b) and then divide by 4 Total gallons:
To calculate gallons by dimensions give above: (a)(b)(c)(7.5) Total gallons:
Consumer Confidence ReportSystem Notifications
I, the undersigned customer, do swear that the above information is true and accurate to the best of my knowledge,
and I do understand that during a 12 month period only (1) pool adjustment will be given.