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New Meter Installation Request Form
Date ~ / iJ-/ ()3
Time 61pLh
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Account Name j{)i1JOJI ~
Address /5/3J ~ /JtV)(} AJW
Account # ~J.l.jJfJO
Meter size
57ff I { .IV I? ~ /u.-- b ^
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Meter SIN
7 7 0/ 91+3 Z- I J\
MTU# t!fo~7 ()~ 94-
Check the following:
Flow \.J Meter seal ~ Main on J
Comments
Installed by r.r r1 In fi