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Appendix B
Gas Service Installation on Hold Form
Your gas service installation from the street to the gas meter box has been put on HOLD because:
This is a Designated Area: The gas meter box must be installed on boundary or an open trench provided.
There are building materials, etc., on the line of service.
Scaffolding is in the way.
The gas meter box is in non-complying position.
Gas meter box recessed too far.
Scaffolding is in the way.
Gas meter box set too high / low.
Footings protrude too far and need to be cut out from under gas meter box.
Permission is required to remove paving under the gas meter box.
The section at the bottom of this form can be used to grant permission to lift paving or break out concrete.
Please sign and leave in gas meter box.
Please note: it is the builder’s or owner’s responsibility to replace any paving under the gas meter box or driveway that may
have to be lifted.
Other:
Whentheaboveconditionshavebeenrectied,andtoreschedulethegasserviceinstallation:
Please contact __________________ (contractor mobile phone) between 8 a.m. and 4 p.m. or the ATCO Gas Australia Call Centre on
13 13 56 between 7 a.m. and 6 p.m. and quote the address, job notication number and the reason (on this form) that was given for the
service being put on hold.
Note: DBYD plans may need to be re-applied for. Allow 7 to 10 days for the installation of the gas service from the date of contact to
re-schedule the gas service installation. Line of service route to remain free from obstruction for this period.
Permission to Remove Paved Surfaces under Gas Meter Box:
I (print name in full) ________________________________ grant permission to the above request and take responsibility for repairs and
reinstatements required in the installation of the gas service.
Your Gas Service Installation Has Been Put ON HOLD
An ATCO Gas Australia Service laying contractor visited this site to connect the new gas service.
This service line is to be connected to the gas pre-laid service (adjacent to the water meter).
Connected in a straight line out to the boundary.
The gas service must be installed before the driveway and cross over is installed.
The gas pre-laid service (PLSS) is under the stairs, terminating at the top of the stairs.
ATCO Gas Australia Job
Notication No
.:
Date
Address:
Signature:
Date: (dd/mm/yyyy)
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