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New Meter Installation Request Form
Date
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Time
Account Name ~ D. tJb
Address /53lft+ LtjJJrt ~~ CL lJuJ
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Account # IX) t;; ~a 6et)
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Meter size
Meter SIN 4-739 I 7 f3 Cf ! ~/
MTU # ;JD _~ 7 0 Z-.. 9 0 v
Check the following:
Flow ~ Meter seal 1./
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Comments
Installed by
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