Water Meter Change Form – FOR OFFICIAL CITY OF YAKIMA USE ONLY

FOR OFFICIAL CITY OF YAKIMA EMPLOYEE USE ONLY!

Water Meter Change Form – OFFICIAL USE ONLY

Water Meter Change Basic Info

**FOR OFFICIAL CITY OF YAKIMA EMPLOYEE USE ONLY. ** There is no confirmation notice sent once the form is submitted.
MM slash DD slash YYYY
City of Yakima Employee Name(Required)
Hold CTRL button to select multiple items if you’re using the form from a desktop.
Hidden
Meter Change Made

OLD / PULLED METER INFO

Please enter the information for the meter that is on site before any changes are made to the meter in this section.
If no meter was pulled, use same meter number that’s on site.
If there was no meter component pulled, just put 0 here.
Old / Pulled Meter Model Type(Required)
If no meter was pulled, just enter 0.
Reason Meter Was Pulled / Changed

Photos of Old Meter Components – *Required*
Accepted file types: jpg, jpeg, png, gif.
Take a photo of the old register with the final read visible, and endpoint # before they’re destroyed whenever possible. If you’re unable to take a photo, you may be asked to verify info it it is conflicting or incorrect.

NEW / SET METER INFO

If no new meter set, enter same meter number that’s on site or type SAME in box.
If no new meter was set, enter 0.
New / Set Meter Model Type(Required)

If no new meter was set, just enter 0 for the #.
Photos of New Meter Components – *Required*
Accepted file types: jpg, jpeg, png, gif.
Take a photo of the new register and endpoint before they’re installed whenever possible. If you’re unable to take a photo, you may be asked to go back out to verify info it it is conflicting or incorrect.

ADDITIONAL METER INFO

Hold CTRL button to select multiple items if you’re using the form from a desktop.
Hidden
Physical Meter Location On Site
Meter location description that is other than the directions options above.
Hidden
Meter Status, Other
Meter Set Type

Whatever type is connected to the meter on the inleg.
Meter Shut-Off Type

City Service Line

If line is visible, please select correct option.
Customer Service Line

If line is visible, please select correct option.
Tile

Street

Land Use

Hidden
Employee Certification