Service-Line Request for Eureka residents.

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 Field


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#:

Enter a mailing address if different than the service address.
Address:
City:
State:		Zip Code:

Please enter phone numbers, including area code. Use numbers only (no punctuation):
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. View an instructional video on how to find BTUs for appliances in English or Spanish.

	Type & No	BTU's Per Appliance		Type & No	BTU's Per Appliance
Furnace:			Barbecue:
Water Heater:			Range:
Dryer:			Fireplace:
Pool Heater:			Garage Heater:
Space Heater:			Gas Light:
Patio Heater:			Spa Heater:
Boiler:			NGV:
Gas Log:			Cooktop:

Other: (please describe)

Would you like information on natural gas equipment?

Yes

Comments:

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