2000_0914 Ay & c ../.t e7
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WATER
taenea TPOOFaisbect / 1.f o U P
:Aid Le---/14._a___ Address: / ? h_ ✓.,e./ i - C - .Q._
Phone N.r..cer: ( __92, -27...L.90 (W'K).
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Check Far: a curxy =: m Leak: 2------ Cluck water pressure:
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Inidat *ccer reload= iase=ices Re -read
1. Back taw [mn. 2. gamic 3. Main 4. OW
Bacdow tnv. A. Main Line A. Pump . A. Lies Loeuse
B;c:'.ove Cr Dace B. Valves B. Water Tower B. Line Locate
(t : -C_:_ Dace C. Service Line C. Samples G Tip
D. Hydrants D. Equipment D Exavatioa
E. Safety
S. Reason for felt= A. Electrolysis B. New Coesto cdon C Poor tasolidoa D. Other
6 . List of safety equipment* site if app&icabk
A. Barricades B. Cases C. Tape D. Lights E. Other .
Request r r Service i !_, ef :;, / 4 �'- `i % '
42- 7. Ii Me a Service Lamle Gasify: - City: Custer
A. weer Loss (es oe): GPM Fire plug flushing Total Gallon
B. Was Weer Meaet & Yes No
C. Wu Cosy Notified: Verbally Doodmodcx -
VehicieEquipasent Used
3. (` ::: `=an3s C .: Ccit T Ales Hrs Equipment
N( : ::: - fi y Reading V1/3
3. New Mete: ? 2 6 S Reading ...A"--- C. Old Mr= 5.r."7:-.;e: 5 /f � CA(Y D New Meter Siz :T•ype ' -3y 4 2246
E. Type of work per.orsned or Sidings: 4 014 i � ? L G‘ao'' Q
9. (c =3_.r.: or -.!es; iertic_ :•epair, describe type of pipe or ser'c :line a:d a dition:
;') . '.::.--.:_:1 J C::.J. M: - :e :s. 6
I t E.:3: `•:.l: :-ia the:.
�v✓/'> - c.? .
12.:: I.: 3::...... r. :;._:ic ..i.h.ts •e :kilning this :scuts:. Ocd !au . :c :C� v:s ::::c
13. Wi::: (,alines Tr.:: is eccior : or fail
14. Slog many trip i A Isk".' / Z ,__,,,-