Low Income Wastewater Utility Reduction Program & Fire Suppression Assessment Fee Waiver Program Application

CCSD Customers who participate in the CARE program through PG&E may be eligible for CCSD's low-income wastewater utility reduction program. This program allows for a 40% reduction in wastewater fees. Property owners may also receive a fire suppression assessment fee waiver. Please contact our office for more information. Eligibility requirements include:

Completion of a CCSD Low Income Wastewater Utility Reduction Program Application.
Copy of your CA driver's license or ID card. The address on your card must match the PG&E service address.
Documentation of participation in the PG&E Lifeline (CARE) program.

Applying for (required)

Wastewater Rate Reduction (low-income discount)

Fire Suppression Assessment Fee Waiver (owners only; no tenants)

Is this an annual renewal?

Account Number (required)

Applicant's Name (required)

Service Address (do not use a PO box) (required)

Telephone Number (required)

Name on Bill (if different from applicant) (required)

Check here if you rent and your utility bill is included in your monthly rental

Copy of Current CA Driver's License or CA Identification (required)

Copy of Latest PG&E Bill Showing CARE Program Eligibility (required)

**NOTE: Service Address MUST match CA Driver License and PG&E bill**

Applicant's Signature (required)

Date: (required)

THIS SECTION IS FOR THE OWNER OR MANAGER OF A MULTIPLE TENANT PROJECT

I understand that for an eligible household to receive this reduction in a multiple tenant project that is on a single water meter, the owner must agree to pass the savings on to the qualifying households. The owner must also agree to allow District to audit project records verifying that the savings are being passed on to those households. If a rate reduction is approved for eligible households in the project I agree to these conditions.

If all the information is not provided, my rate reduction may be denied or delayed. The information on this application will be used to determine my eligibility for the Low-Income/Fire Assessment Waiver Program and/or the CCSD's Wastewater Reduction Program rate. I understand that submittal false information may result in the District discontinuing the discounts.

Owner/Manager Signature

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