Service Line Request for Natural Gas in Eureka | Project

This form is for new home or business construction, conversion of a home to natural gas for the installation of new service lines.

Be advised that installation times can vary between six to eight weeks after receipt of request.

* Required

First name: *

Middle name:

Last name: *

Company name:

Enter the address where you are requesting gas service.

Street address: *

City:*

State:

Zip code: *

Subdivision

Lot number:

Is the mailing address the same as service address? Yes No

Enter a mailing address if different than the service address.

Address:

City:

State

Zip code:

Please enter phone numbers, including area code.

Home phone: *

Work phone:

Cell phone:

Fax:

Email address: *

Our standard meter location is 3 feet back from the front corner opposite of the garage.

What type of meter pressure do you need? * 4 oz. 2 lb.

Please indicate the type and number of all gas appliances to be installed. Also, if available, enter the total number of BTUs per appliance category.

Furnace:

BTU's per appliance:

Barbecue:

BTU's per appliance:

Water heater:

BTU's per appliance:

Range:

BTU's per appliance:

Dryer:

BTU's per appliance:

Fireplace:

BTU's per appliance:

Pool heater:

BTU's per appliance:

Garage heater:

BTU's per appliance:

Space heater:

BTU's per appliance:

Gas light:

BTU's per appliance:

Patio heater:

BTU's per appliance:

Spa heater:

BTU's per appliance:

Boiler:

BTU's per appliance:

NGV:

BTU's per appliance:

Gas log:

BTU's per appliance:

Cooktop:

BTU's per appliance:

Other gas appliances:

Would you like information on natural gas equipment? Yes No

Comment:

If you have any questions please call Customer Support at 800-323-5517.

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