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ADDRES~ 3~ 5 9
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ACCOUNT It
OLD METER
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Ser. No.
~ If 60 S-04 '7/
Ser. No.
Digit!"
Reg. No.
03/1; TJD j
Size
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Reading
MIU Ser. No.
003SS-';; ?
MIU Phone 1#
Bldg. Type:
Port 1
RPZ Installed Yes _ No -
RPZSer. No
Service Size
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Type
Ground Yes )( No _
Lead
COMMENTS'
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NEW METER
/(/A-
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Copper ~ Iron Pipp
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INSTALLATION ACCEPTABLE. WATER M,E~ERSEAL WIRE 1~,PIfCE.
OCCUPANrs SIGNATURE-W_1t1A),u~ A ..JA
DATE q -20 - 2.Pt? A PHONF
Form 90080 (4-93} Copy lCustomer Copy 2 WS
Copy3&4WD