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Electric Service Meter Base Verification Form

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This form must be completed by the Owner and/or the Electrical Contractor prior to service connection.

Building type:
(please check 1 of the following)
Is this work required for:
(please check 1 of the following)
Sketch the Front View layout of the Electric Meter Bases, for each meter base, write the Unit Number and the meter number if known. (See example at foot page as a reference.)
Accepted file types: jpg, png, pdf, Max. file size: 6 MB.