Service Installation Record
Instructions: Complete and submit this form.If gas is required for the first time
for this location, please call 1-888-280-2938 between 8:00 am and 4:30 pm Monday
- Friday to determine if gas is available.
Forms not legibly completed in their
entirety will be rejected.
NOTE: For NEW service line installations, this form will not be accepted until AFTER an application has been submitted by the responsible
party and received and approved by Peoples Natural Gas.
Note: By signing this form, the installer attests that they installed or repaired and tested the service line and/or meter in accordance
with applicable codes and standards including, but not limited to:
1. Material used in this installation meet Peoples Natural Gas' approved standards
2. A tracer wire that is of 8 gauge solid copper wire with a yellow thermoplastic coating
was installed (All services)
3. Tracer wire was properly installed and checked for continuity across its entire length
4. Service line is installed at a minimum depth of 12 inches or encased
5. New service is not run under steps, porches or crawl spaces
6. Meter manifold installed does not block a fire escape
7. Meter manifold is properly supported
8. Meter manifold is protected from vehicular damage
9. Meter manifold is not closer than 3 feet from an ignition source
10. Meter manifold service line is properly supported.
11. Meter is accessible and as perpendicular to the main as possible
12. New meter manifold valve installed
13. Service must be run to the street to which the structure is
addressed, unless given permission by Peoples Natural Gas
14. All exposed piping must be suitably coated to prevent corrosion
1. He/She is Operator Qualified in accordance with the requirement set forth in 49 CFR 192, Subpart N. This means that the installer has been evaluated by a
Peoples Natural Gas approved third party qualifier and has been deemed qualified to perform the various covered tasks associated with installation of natural
gas service lines. (3 year re-qualification required)
2. He/She has been evaluated and qualified by a Peoples Natural Gas approved third party qualifier to join plastic pipe utilizing mechanical couplings. (1 year
3. His/Her employer administers a Drug & Alcohol Testing Program that meets the requirements of 49 CFR 199, including random testing.
The installer understands and agrees that by performing the inspection herein and accepting this form and stated qualifications of the installer, Peoples Natural
Gas is not assuming nor accepting any responsibility or liability for the installation or repair work performed by the installer and that the installer remains solely
responsible for any work performed. Further, installer agrees to indemnify, hold harmless, and, if requested, defend Peoples Natural Gas, its officers, employees
and agents from and against any and all liabilities, costs, claims, demands, fines, penalties, suits (including cost of defense), proceedings, actions, and causes of
of actions, including reasonable attorney's fees arising out of, or associated with, or related to the installation described herein.
Form No. 700116 (Feb 2019)