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l\lJ:l'LJ Installation. Request Form .
Date 5/1 3/0~-"
Time alU.1..~'
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AccoWlt Name ]x;/fI/\ c/jZJJ7l.P<J
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Address &36-;? ~ _((h~/ ~_k j(Jb
AccoWlt.# (fJ(J ~sqtm
Meter size 5/8 J( n l'j C) 0 0 / 6
MeterS/N-B 008.5'5f7
MTU#-fJO~ 55"97
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Check the f?l1owihg:
Flow j//Meter seal ~ Main on V-
COllunents 0 //~ / Ob-
Installed by F? .