Freeport NIP(3)-WO 951023Code: . .
!
Tota~ Gallons
Door F~nocker
If Meter Change Out
O1~ Heter 9:
New ~ter ~:
O1~ Re&itng:
New Re&~h~ng:
Puzl~ose for Changing Mete.c:
c..--~--: Z. 5'
List MaCer~all Ule~:
14&CeZ~a.L Cost:
Total
Note: paVlOontP~pa/.cRmq~ost S"~'4t~: ~ea NO