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New Meter Installation Request Form
Date .JJt~a aLL c f/ t ( I ~ 3
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Time (;.Jl ~J.r.l /u (j 1 tiu j ) I ?ll7 t/ j J-
Account Name hLLtL- & / )U~J /
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Address :5eoq B tiL/' j f::)c:tJ ~)J, ~/:
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Account t~o ?3 0 7 eo
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Meter size ~ (') ~~c 8 (')
MeterSIN J 7 7 & t, 9~!h /
MTU# ~~.57o~!~
Check the f1lowing:
Flow V Meter seal
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Comments
Installed by FP 4 In ')