CCWD Customer Service Inquiry Form

Please submit a completed form summarizing your inquiry. Once you submit this form, it will be routed to the appropriate department to assure a quick response and solution. We are committed to providing excellent customer service and will contact you within two business days after submission. If this is a water system emergency, such as a major water leak in the roadway, please contact customer service at 209-754-3543.

Contact Information

First Name*

Last Name*

Email Address*

Phone Number (XXX-XXX-XXX)*

Phone Type*

Home

Mobile

Work

Are you a CCWD Customer?*

Yes

CCWD Account Number

Service Address

(Street Number, Street Name, City, Zip)

Service Request

Issue*

Please select the best option related to your service request.

Select

Billing, Payment or Administrative Inquiries.

Please select the best option related to your billing, payment or administrative inquiry.

Select or enter value

Water or Wastewater Inquiry

Please select the best option related to your water or wastewater inquiry.

Select or enter value

Description*

Please provide a clear summary of your inquiry. If you are requesting information about a new connection, be sure to provide an APN.

Attachments

Please upload any photos or supporting documents, if applicable, to better assist CCWD staff as they are addressing your request or inquiry.

Drag and drop files here or

Send me a copy of my responses

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