Vistas of C P3-CS000429ja" 0J - Zq _ 0- P.O. Box 47
The City With A a..: ,,Future ',{,
255 PARKWAY BLVD.
COPPELL, TX 75019
FAX NO. (972) 304 -3570
ENGINEERING DEPARTMENT
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NUMBER OF PAGES (INCLUDING COVERSHEET): C G
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IF YOU DO NOT RECEIVE ALL OF THE PAGES, PLEASE CALL (972) 304 -3679.
Engineering - Excellence By Design PLC, 57 v�
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Phone
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(WK):
Check for Accuncy :esc: Nieter Leak:
Ittittal meter reloe4tioc ins
Cheek waver pressure:
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Re -read
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4. gft
Back-low lnsp. A. %laia Lute
BiL3ow Ce- Date g valves
` . Pump
A. Line Locate
R: -Cm Date C. Service Line
B. water Tower
C. Samples
B. Line Locate
D. Kydraat;
D. Equipmeat
C. Ta
D Excavation
E. Safety
S. Reason for failure .t Mwtmlysis B. Neer Cvaaaveaon C Poor IMUQ& m
D. Other
6' List of safety C*jPmm at site if Vlolimbk:
A- Ban"'M B. Cones C. Tape
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D. Lights 8.Otha
-
Request fqr Services:
ST3
( � ! oil
1 f • f
7. f. xr rSetYic e leak: Classify: • tty.
unto r
A. t .tisrer Cos; (eSrate): GPM �� Fire plug flushing —�,___. Total Gallons
B. Was ara� yfe�ed: Yes No
C. was Customer VotiFed verbally Doorknocker - •
3- If `;e::r Caaag: 0�,: Vehicle/Equipment Used
L tut 4 kyles Hrs Equipmeat
A. 0'd .Xvar = Reading
3. `ear Mere- # Reading J
C. Old Meter SizzT!ge;
�
E. Type of work petlormed or rwftgs: 0 -New Meter Size.T• � e
9. If 'TA a ere Or deep 3er " repair, descrtbe type of pipe or service line and cooditiou;
C
1 l L :s. Ule .
4:Ir Per f or. -tong this :. o you c_;cr. it' Yes ac ro
13. Wwer utilities rre:e. erection pass or fail
13. H OW M4.'t Q•ips to :o Wu"
04/27/00 08:30
is3tted: T/,
972 304 3547
CITY OF COPPELL 4 CITY OF COPPELL
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WATER
NO. 02? D01
Grid taap: V 15T S , r` - 3
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