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New Meter Installation Request Form
Date
~LlL4d~a, VI IDP)o3
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q.' /5 am
Time
Account Name p~
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Address WI./ /jb-i6 ~ J; 0E
Account O~50?ctJ J .
Meter SIN
67g (f
.
77 7fi,foCff; IX
Meter size
MTU # 0 (;) '5 7 CJ "';,5' /)
Check the following:
Flow .~ Meter seal 1/ Main on /'
Comments ~tuc + rn T() r~ns~'
(P /J JR;; ;2.1)91
'Q U/J -& t at /) aflL!J, Ptum.j;u, 4
Installed by rr p d k 8 '