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l\IJ.'l'LJ Installation Request Form
Date I //cJ!1/orj
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Time f1!1'ttr~.
Acconnt Name ~ k. ~ffLfb,1 '
Address / 7l/ & I h Vli-uf rL J:y $
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Acconnt # f}(j~ 7 55JTJO
Meter size 51 ~ I ( ~ & 0> c> G. (;) ~)
MeterSIN 79/399730
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Check the following:
Flow Y Meter seal//'
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Comments
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