Service Request Form

2. Should a problem require immediate attention, please call us at (301) 829-1424. For a police emergency, dial 911.
   Thank you!
4. Contact Information
6. First Name*
7. Last Name*
9. Your Address*
11. Apt/Suite/Unit
13. Phone Number*
14. Email Address
16. Please indicate the nature of your problem by checking the appropriate box(es) below:
18. 1. Traffic signals
    2. Water leaking
    3. Street Lights

    1. Storm sewer leaking/blockage
    2. Water leaking on roadway

    1. Loose/protruding manhole cover
    2. Missing Water or Sewer Caps
20. Brief Description (or other problem not listed)
22. Location of Problem*
Leave This Blank:


24. Submit

* indicates a required field