SC-Coppell HS-WO000329Issued~ Fi~dshed:.,
N~..e:
Phone Numi'.e::
Employee ~ Grid map:
! ~
Check for: Accu.r~cy :est: Meter Leak:
Inidal me:e: retacation
Check w~ter pressure:
Re-read
1. ~ 2. Reualr
I. ,.~faln~en~nce
Back:Iow [.~.. A. Main Line A. Pump A. Line Locate
Bla]ow Ce,"_ Date B. Valves B. Water Tower B. Line Locate
R.'-Ce.-'-_ Dare C. Service Line C. Samples C. Tap
D. Hydrints D. Equipment D Excavation
E. Safety
5. Rea.~oa For failure: A. Elec~ol~is B. N~w Comsmiction C Poor I~s~l~ion D. O~her
7. If Meter;Ser,'ice Leak: CLts~i~: - City:
A. Water Loss (~,ate): GP.~! __
B. Wss Wa~er .~fe~r~d:
C. W~s Custo~r.~'~'ied: Verbally
Fire plug flushing
No
Total Galloms
Doorlmcck:r -
Vekic!e[Equipment Used
Unit # Miles l-L-s Equipment
A. CCd Me:er i Reading
B. New Mete: ," R~ding
C. Old Metz Siz'.T?'pe:
E. T.w~e ofwoi ix~.'on~ed or £mdings:
D New ,~feter Siz~"r~e.
9. If ma"~l~"e or dew serdce repair, describe ~pe of~pe or service line ~nd condition:
Lis:
Crew Nl.~n.~:¢rs.
13. Wa:er Utzltties me:er '..~ection: p~s or Fail
M.. Ho'.,, man? ~'ips .~o do :ask?
Signature