If this is a medical emergency, please call 9-1-1.
Use this form to make a claim for injury or property damage. This form is provided pursuant to state law (Government Code Section 910 et. seq.) and shall be used by any person presenting a claim to Vallejo Flood & Wastewater District under Government Code Section 810 et seq.
Specify particular expenses, estimated prospective injury, damage or loss, general damages, and so on. Please attach copies of bills and/or estimates, as appropriate.
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