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What is your request | | |
Turn off water | |
Turn Off Water: Date for requested action Required | | |
05/31/2023 | |
Turn Off Water – Meter Reading Required | | |
1234.567 | |
Turn Off Water – Serial # Required | | |
123-45 | |
Lateral Selection | | |
0DRN | |
Turnouts for Lateral 0DRN | | |
PMP | | Contact information | |
Name | | |
Test | |
Email | | |
jmatta@bcimedia.com | |
Phone # | | |
(123) 456-7890 | |
Remarks | | |
This is a fixed test. |
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