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ADDRES~
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ACCOUNT #
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Ser. No.
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Reg. No.
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MIU Ser. No
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MIU Phone #
Ground Yes _ No _
COMME~TS: ~h~
Lead Cop""r
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Iron Pipp
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Bldg. Type :
Port 1
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RPZ Installed Yes _ No -
RPZSer. NC"
Service Size
"0 Type
Please keep this receipt for your records. The final reading from your old w-.ter meter
will be used in determining your next re~lar bill.
If you have any questions or problems, please contact the Water Department durin9.1
normal working hours. Thank you for your cooperation.
-----------------------
INSTALLATION ACCEPTABLE. WATER METER ~EAL WIRE IN PLACE.
OCCUPANT'SSIGNATURE~ ^ ~..
DATE Df-:t'-o--v- , PHONE<t,JJ/Q~~..2..fi
Form 90080 {4-93} Copy 1 Customer Copy 2 WS Copy 3 & 4 WD