2001_0925 •
. WATER -
tsniet Faiske± ; 5
P'.t a S:. -�G Mil S L L ('� �_ _
(wKk
Check :Ix A :vac.► = Meter LeaSc • [aie.a! =ecc csiom:at *4=i as � Pe' ,
1 Hxft: ?a+r rasa_ 2. Milk 3. Saia 4.
Hues.. (=cp. A. %(aia Lisle A. p : tins Ladle
3w C- Oue 8. Valves 3. Weer Tsgix S. Lint Laea e
it :-Cm Ore C. Service Line C. Samples C. Tip _
D. Hydrants D. Equipraeac 0 &eaysdela
E Sam
£ taxa Sr ea= x Elozzalysis a Lis. C C Pace feeddatD. D. 1
6. Lot ea* *pippins as irapptiesbie
A. Bactiea B. Canes C Taps D. Lights E Max .
Ft :cuex o $arcs J 1 -I- e. 4^ C I- ) c.N.J �y P t, t 4 •
7. ri M Se:vi C Cacti fy: - City: Castim:r
A. wzar Lae (:s"a0e): GPK Hire plug tag Taal Canoes
9. Was Wye,"""*, Yes No
R Verbally C. u Cum= `ccBed V y Uvcdmodcx .
V:E.azquipcceit Used
3. ,........ �.: ;: ^: L' c T NCla F.rs Ei :ipecet t
•
:.. ■,(_ : : : a Cie 7 z- q f4 T 1C)9- -1L
3. `c-v Me= : 2 t i i !.51a7 Etadiaf
C. Old Mr-- Sxs :; Vic: Pp i ^C.-042 i 5/' F :�c74:c:c Si =tne j4Z 4146G".Vg
E. Inc stater ?crammed a findings:
9. (:.1___ :c'.:— ;c- % :- ::a.., describe :me oC pipe arsrrric:'..::e tc3 :t:cd'idcc.:
;) ..... _. ` d-- C::.v m: - :e :s. bt \ (1
I ! f...;: •4:'.-1a :::e..
1 C: C: :. _.... _ :..'.: t: ' +.'. ::: r4::CCItli.t3 this :..its:. O:d ./1.1:::c.-: -.c? ? :i ::::c
II vi L':: LQItdes TX.r... •Settian: � / ac rail