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Always indicate specific section on sketch if multiple values for material, method of installation, size, or year installed (if year is available) are applicable to a single service. <br />Not intended to be inclusive <br />of all possible symbols. <br />This section is <br />for reference only. <br />----GasLine(New) ® Meter Anode <br />-4- Reducer 1W0R-0-EFV-()--ValvewithFrame and Cover <br />�„E�•, <br />Gas Line (Existing) ® Meter Manifold ® Electronic Marker <br />�ServiceTee � OR Cap Pipe Size and Material (Casing Size and Material) Inser <br />•Main <br />•Material <br />• Name of nearest cross street <br />Instructions <br />for Deactivations: <br />v <br />•Service pipe <br />El <br />• Method of install per <br />•Name of street <br />The <br />following is the minimum Information require <br />•Servicetee <br />*2 <br />v <br />TD -4461M: Trench, HDD, <br />.North arrow <br />when <br />documenting deactivations on the GSR. <br />• Pressure classification: High pressure (HP), <br />M <br />V <br />splitting, dry bore, insert <br />_ <br />• Street address <br />• Location ofgas fiowtermination <br />2 <br />semi -high pressure (SHP), law pressure <br />d <br />U <br />•Pipe size <br />a <br />• Dimension service tee to service end <br />• Installed assets related to deactivation(e.g. <br />(LP), transmission pressure (TP) <br />• Status: New or existing <br />• Dimension service tee to nearest cross street <br />electronic markers, end caps, plugs) <br />`o <br />• Existing pipe: Year <br />= <br />o <br />• Deactivated pipe: Length, material, size <br />• Mother/branch service= <br />Casing length <br />.n <br />c <br />• New cathodic protection (e.g. anode) <br />v <br />installed, if available <br />Deactivated pipe length <br />• Deactivated pipe: Year installed, if available <br />cL <br />• Casing material <br />v <br />°1 <br />— <br />n <br />• Deactivated pipe <br />V <br />E <br />• Width of cross street <br />`o <br />• Date deactivation work was completed in <br />• Electronic markers <br />a <br />g <br />•Casing size <br />w <br />Repairs: Dimension from service tee or riser <br />.0- <br />• <br />accordance with TD-950OP-16 <br />. Fittings per TD -4461M <br />gs p <br />= <br />•Joint trench (JT) <br />= <br />and length of repair <br />S <br />v <br />L <br />,LAN ID and signature' or printed name of <br />m <br />d <br />- <br />•Curbvalve <br />• Excessflowvalve <br />Pipe <br />P <br />c <br />°1 <br />• Partial replacement: Dimension from service <br />..•g <br />c <br />m <br />thequalifledfield representative <br />performing required testis) and/or <br />F <br />A <br />• Meter/manifold <br />if <br />2 <br />•Material <br />• Type: Main or service <br />a <br />3 <br />tee or riser and length of installation <br />. Stub completion: Dimension from service <br />o <br />m <br />inspection(s) <br />, <br />n <br />• Pie casing <br />P 8 <br />m <br />$ <br />• status: New <br />o <br />- <br />tee or riser and lenth of installation <br />g <br />• IAN ID and signature or printed name of <br />w <br />•Regulating stations involved in or within <br />d <br />'Q <br />system status: Tied or <br />' Ys (TI <br />3 <br />,r <br />, Manifold or large meter: Dimension <br />the person in charge responsible for <br />close proximity to work <br />s <br />g <br />°� <br />dead end (DE) <br />_ <br />minimum distance required between <br />installing assets and performing work <br />e <br />, Meter guards <br />• Existing pipe: year <br />structure and riser <br />related to deactivation <br />m <br />• Met hod connection per <br />o <br />installed, ifavailable <br />.Lateral offset: Dimensionfrom servicetee <br />'Ezcevation Agent: PG&E or Applicant <br />4-t <br />TD-9500P-1P-14JA01A <br />ai <br />•Casing material <br />or riser <br />•Deactivation order reference <br />$ <br />•Deactivated non -pipe assets, if <br />= <br />9. <br />•LAN ID' ofqualified individual performing <br />a' <br />•Casing size <br />. Valves and fittings: Dimension from service <br />8 <br />connection <br />Joint trench (Inn <br />tee or riser <br />available: material, size. <br />