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New Meter Installation Request Form
1
Date Ob / c:2 / [)3
Time Llttf;11 /C'O>"\
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Account Name ]) ~ ~ -/r/l/\.
Address 07JD.;) [J~g A ~~" ~ 0b
Account tiJ ~dl.o Jm \/
670/1
Meter size 0
MeterSIN 7 7 7~ C, 9 9 b ,/
MTU# ~c>57oc>32-
Check the following:
Flow V Meter seal Y'
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Comments
Installed by ,t::.p. h? ~
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