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PRE -INSPECTION REPORT )
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Dates: Address: r
Jurisdiction: City / Zip:
Right of Way Permit? :YES [1 No TM Customer:
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F�GGERS # ....,
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TROLLY LINES
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( ] METER HOODS fD
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OFFICERS # y _ SPEED L ff
TRAFFIC SIGNAL
( ; " ARTERIAL
NO PARKS #
Commercial ❑ Altered Commercial
Leak Repair
Service Information
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CP Work
Meter
EFV
0 Bollards 23' #
Multi -Family ] Replacernent Service ]
Rotho;e
E] 5/8"
Ej 250
❑ 1800 FjBollards 4" #
New Constr. Main Maintenance,
Extension
EJ11/8"
[] 425
2600
(] Stuh Service Maintenance
E] 11/4"
0630
E] 10,000 FUEL LINE PERMIT NEEDED
[] I xtension valve Maintenance
Lj 2"
❑ 1000
Fuel Line Length:
(.._] Compete Seri [_j Cut & Cap
Mtr Loc:
Fuel Line Diameter:
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