209 Basilwood 6 u,/ p1&-74
•
.
W *nut
I: ,,ice, rung .----- •
ace:
-A -� _ / / ' Geed
Phors `r..cr.. (Ffti{} ' d Address: 40 li _ _ 00
(wxr
Check for. :Sicxv ,; Meter Leak Check water pressure
Inidai mete; t elomtlen moat Racal
L. Back:1aw (ggg, 2. &WE 3. Main i. CISINt
Bse ow asp. A. Main Line A. Pump • A. Line Locale
Bk.:log:C.1n Dace B. Valves B. Water Toed & Live Locate
at-Cm Dave C. Service Line C. Sampks C. Tap
D. Hydrants D. Equips= D E vaQOa
E. Safety
S. Loa hoc bil= A. Ere troIy� D. New Cant w C Poor Inter toe D. Other
.
6. list of safety atipmmt at lie if applicable
.4.�Baeriada H. Coon C. Tape D. Lights E. Other .
Request for x � - ' . � C -r bf Y �C.e �'��- C'-Q1C . 6J (�
7. If Met Servic L=Sc Classify: - City: Customer
£. ster Lost ( err ): GPM Fire plug &thing Toed Caallous
B. Was Waterer Yes No
C. Wu Cos= golfed: v -
�IY Dooclmodtx -
V hic!erEquipmeat Used
3. r Mt::: � zi.:;: C .%_ `NCles Firs
Ccit � Equipment
•
A. ,:. .Me._. ='1 /! /T To t2 Reading 7 irS
3. Nevi Mete: 3 1, 6 " 9 D L Rading 4'
C. Ord Meter 5 -: pe: D New Meter Siz= ?fie £7l ac' / r,." /47
E. T.vpe of t performed. or findings:
9. t =3=-:::e :r =e-: ;err :: Nair, describe type of pipe or se: 'ic_ tine and coedidoa:
',.7 7.:1. is C : :•u }(: -x :s. 6 11
I ! C:;: %:.17:7:3:3 r';e.
I _.. _ i.: is :. _.... _ :.des: .4•::..!:: pe: fc.:.iict3 this :rue-sr. D:d . .e.:u :c- .c? Y:s :::
l 3. viz::: C:ntires me:: . ..tr;.ection: , or fait
14. Hom .:.L''! tits 72 :o Ilk? 1 ��/