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.

Date of Meter Change(Required)

MM slash DD slash YYYY

City of Yakima Employee Name(Required)

Name

Location Address(Required)

Account Number

If there is no current active account, you can note that instead of the account number.

Meter Change Made(Required)

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Meter Change Made

Pulled Meter – no new meter installed

Set New Meter – no old meter on site

Changed Meter

Changed Meter Body Only

Changed Register

Spliced Endpoint

Other

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.

Old / Pulled Meter Number(Required)

If no meter was pulled, use same meter number that’s on site.

Old / Pulled Meter Read(Required)

If there was no meter component pulled, just put 0 here.

Old / Pulled Meter Model Type(Required)

New meter set – no pulled meter info

ADE – B-M35-3/4A – 3/4″ – 65 – Read 4 of 6 dials

HRE – B-M35-3/4H – 3/4″ – 53 – Read 4 of 8 dials

HRE – BA-M25 HRE – 3/4″, 5/8″ – 53 – Read 4 of 8 dials

HRE – B-LP-5/8H – 5/8″ – 53 – Read 4 of 8 dials

HRE – BLP5/83/4H – 53 – 5/8″ – Read 4 of 8 dials

HRE – B-M55-1HRE – 1″ – 53 – Read 4 of 8 dials

HRE – B-M70-1H – 1″ – 53 – Read 4 of 8 dials

HRE – B120- 11/2H – 1 1/2″ – 54 – Read 5 of 8 dials

HRE – BT16011/2H – 1 1/2″ – 54 – Read 5 of 8 dials

HRE – B-M170-2H – 2″ – 54 – Read 5 of 8 dials

HRE – T-200-HRE – 2″ – 54 – Read 5 of 8 dials

HRE – BM-T450-3H – 3″ – 54 – Read 5 of 8 dials

HRE – T-1000-4H – 4″ – 54 – Read 5 of 8 dials

ADE – M25 ADE – 3/4″ – 65 – Read 4 of 6 dials

ADE – B-LP-5/8A – 5/8″ – 65 – Read 4 of 6 dials

ADE – B-M55-1A – 1″ – 65 – Read 4 of 6 dials

ADE – B-M70-ADE – 1″ – 65 – Read 4 of 6 dials

ADE – BM12011/2A – 1 1/2″ – 66 – Read 5 of 7 dials

ADE – B-M170-2A – 2″ – 66 – Read 5 of 7 dials

ADE – BT16011/2A – 1 1/2″ – 66 – Read 5 of 8 dials

ADE – B-T200-2A – 2″ – 66 – Read 5 of 7 dials

ADE – BT3500A8B7 – Compound 8″ – 66, 67

ADE – B-T450-3A – 3″ – 66 – Read 5 of 7 dials

ADE – B-T1000-4A – 4″ – Read 5 of 7 dials

ADE – T 2000 ADE – 6″ – Read 6 of 8 dials

B-M35-4 – 4″

BT3500A8B7 – 8″ – Read 6 of 8 dials, 5 of 7

Old / Pulled Endpoint Number(Required)

If no meter was pulled, just enter 0.

Reason Meter Was Pulled / Changed(Required)

Dead Meter – not reading

Frozen Meter

Meter tampering

Set new meter

Smashed Register Head

Other

Photos of Old Meter Components

Accepted file types: jpg, jpeg, png, gif.

Take a photo of the old register with the final read visible, and endpoint. The photo can be of the pulled meter components after they’ve been pulled out of the tile and the face of the register needs to be clean. If you are pulling a meter only or setting a new meter, use the same photo in each required field. If you’re unable to provide a photo, you may be asked to verify info it it is conflicting or incorrect.

NEW / SET METER INFO

New / Set Meter Number(Required)

If no new meter set, enter same meter number that’s on site or type SAME in box.

New / Set Meter Read(Required)

If no new meter was set, enter 0.

New / Set Meter Model Type(Required)

Meter was pulled – no new meter info

HRE – B-M35-3/4H – 3/4″ – 53 – Read 4 of 8 dials

HRE – BA-M25 HRE – 3/4″, 5/8″ – 53 – Read 4 of 8 dials

HRE – B-M55-1HRE – 1″ – 53 – Read 4 of 8 dials

HRE – B-M70-1H – 1″ – 53 – Read 4 of 8 dials

HRE – B120- 11/2H – 1 1/2″ – 54 – Read 5 of 8 dials

HRE – BT16011/2H – 1 1/2″ – 54 – Read 5 of 8 dials

HRE – B-M170-2H – 2″ – 54 – Read 5 of 8 dials

HRE – T-200-HRE – 2″ – 54 – Read 5 of 8 dials

HRE – BM-T450-3H – 3″ – 54 – Read 5 of 8 dials

HRE – T-1000-4H – 4″ – 54 – Read 5 of 8 dials

HRE – B-T2000-6H – 6″ – 55 – Read ? of 8 dials

HRE – B-T3500-8H – 8″ – 55 – Read ? of 8 dials

HRE – B-T5500-10 – 10″ – 55 – Read ? of 8 dials

Other

New / Set Endpoint Number(Required)

If no new meter was set, just enter 0 for the #.

Photos of New Meter Components

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. If you are pulling a meter only or setting a new meter, use the same photo in each required field. If you’re unable to provide a photo, you may be asked to verify info it it is conflicting or incorrect.

ADDITIONAL METER INFO

Physical Meter Location On Site

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Physical Meter Location On Site

North of property

Northeast of property

Northwest of property

East of property

West of property

South of property

Southeast of property

Southwest of property

Physical Meter Location On Site

Meter location description that is other than the directions options above.

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Meter Status, Other

Meter On

Meter Off

Ring – Yes

Ring – No

Obstructions – Yes

Obstructions – No

Bypass – Yes

Bypass – No

Set Condition Good

Set Condition Poor

Meter Status, Other

Meter Set Type

Copper

Copper Yoke – service line in and out is copper

Galvanized

Pex – city service line will also be pex

Other

Whatever type is connected to the meter on the inleg.

Meter Shut-Off Type

Copper Resetter

Right Angle Ball Valve

Square Rod – Copper

Stop N Waste

T-Head – if mtr set type is galvanized, city service line will be galvanized.

Other

City Service Line

Cast

Copper

Galvanized

Pex

Other

If line is visible, please select correct option.

Customer Service Line

Cast

Copper

Galvanized

Pex

Other

If line is visible, please select correct option.

Tile

Concrete

PVC

Square white lid

48″ Vault – tile lid size

60″ Vault – tile lid size

Other

Street

Asphalt

Asphalt/Concrete

Concrete

Gravel

Other

Land Use

Single Family Residential

Multi-Family Residential

Multi-Unit Commercial

Commercial

Industrial

Other

NOTES

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Employee Certification

I certify that I am a City of Yakima employee.

This form is for official City of Yakima employee use only. This is not for use by the public. If a form is received that has been submitted by a non-City of Yakima employee, it will be deleted.

City of Yakima

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

Water Meter Change Form – OFFICIAL USE ONLY

Water Meter Change Basic Info

OLD / PULLED METER INFO

NEW / SET METER INFO

ADDITIONAL METER INFO

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Business in Yakima

City Services

City Departments

City Government

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