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New Meter Installation Request Form
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Time
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Date ~
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Account Name fl7t-IJ/Jtlll1ri C/Irvof
Address_ c2 7t:)r) LJAfJ/J eX It/ /lI uJ
Account 00 ~ :l7/00 ,J
Meter size
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I O~O 15'~
Meter SIN 4r9 8 5 4-18 q
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MTU# ~. ~,_.~
Check the following:
Flow l/' Meter seal t.,/" Main on ) /"
Comments
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Installed by i1? ~ if ,t::',tJ