Switching Sta-WO 901025 WATER UTILITIES DEPARTMENT
Meter Inspection
La(( r Date :1:mrloyee Making Inspection : — y — �w�.t
1 /
Name of Devel• ent : - ' lar • ia_b5 icti 4 o vl
Address : • 0 rU , , p � , I - -- ----_____— 7-7-
4oLl '/
Contractor : C::t r'i, �I�ir ,r one`: ( �?VI ) s?O -o26,9Cj --
---�' T ?o j V.74 die(
Set Up Account For : �(�_ G�e(,fie-1 c — ----
Address : — o LAILLffe )L ` __— -- ---
Meter
Meter. TYP5 t .two ----
Model : Lu i — -- — — -----
Size : • -- —
Vault : c _ _
Meter Number : amI
L o c a t ' : L• ? -e _ n s__E f � , ,
ith \c , v-e u J . z) # ,Ce 9_
— —Ins ' : e 011 . -- — ----- ---
kA,t's--& /30 k — —
Bnckflow Device (If Applicable)
Type : ___)12L,' 1J L-LL_ ._ — — -- -- —
Model :
Size : — –.— --- ---- --
Vault : _----_ Box : Serial Number : -3 6 .. 5 3
` Inspection Comments : ,8e0 4p�v R .� 4 7'""v �j .@, --_
e Lk T as F o 01- l�41'r-e-, ----- —
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Materials Issued From Service Center
1.4;1 ,4 Division
Name of Contractor/Company :P Y s ck nn ova -�-IN C+3 &o
Project Name : Co �e 11 S,�,bs�FJte4 �rt6 & iet
PP 5
Location : 010 1 . l I,
Materials Issued : 1 - /
lb �'M tl�. 'CC�c.���o•ti �/V(.t„-•e r w q 4.s�Cets � bo l
J
177; 34 7 aa.oi '
Cost of Materials : $ t 4 q , 10
Receipt : Attached YE \ `� NO ,0
Division Supervisor : � II
Individual and/or Compan esena i ,e :
747
c .