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New Meter Installation Request Form
1
Date ~ (//4/0i
Time a ntjC' ~
Account Name 1::lJ< ~
Address f)L// lj. lku fu.1tl (l ~ l){;
Account ()O~, ~ ~(jIYJ
Meter size
67 J'/I
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Meter SIN
-i- -:;- 0; 0 Co Y 3 Z-
MTU#
{)(J ~fo 9 Az-~
Check the following:
F10~
Meter seal
y
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Main on Y
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Comments
Installed bv l '/