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New Meter Installation Request Form
Date //~ L( / /) ~
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Time (} /17l CL./ itA 1,' J 0
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Account Name~...J--rJvt
Address 113'7& {]A Sr;-
Account OOfL; J., q /
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Meter size U /0
MeterS/N 777 (0 Ct, 9 ~7
MTU#~a57 Of '30,
Check the f~lowing:
Flow 1/ Meter seal ;,-J Main on-Y'
Comments
Installed by F' P d /J / 15
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