Gibbs Station 2-WO 930819 City of Cqppell
Water UtiIities
Water Isolation Request
The following information must be provided in order to allow
isolation of any part of the City of Coppell Water System. This
form must be completed and sukm%itted to the utilities Division for
processing prior to the date the isolation
is requested.
Time: A.M./P.M.
Contractor:
Contractors Representative
Area Affected (Street, Block No.):
Water Main Size: ~ Inches
Water Service: 6~ Inches
Water Department Notified:
If water customers of the sy be affected, contractor shall
provide.a list of each of those business or residential structures
affected.
* Note:
The City of Coppell utilities Division shall perform all
water line shut-downs. Contractors are not permitted to
turn any valves in the system.
Contractors Representative
Date
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