Meter Inspection Form

Meter Inspection Form
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MonthDayYear
Location Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Meter Number
Hazards Found

Cut SealDamaged Meter BaseJumpers In BaseMeterbase Not AttachedMast Pipe Not AttachedLow Service WireJumpers Connected To ServiceDamaged Service WireSqueeze-On Covers MissingMeter Not Accessible
Comments
Completed By

First NameLast Name
Should be Empty: