This is the exact embedded text of the captured official document.
Snapshot bb544fcdf928 · verified 2026-06-09 ·
original document ·
archived snapshot ·
unofficial consolidation, the official version is held by the municipal clerk.
CUSTOMER'S WORK ORDER/AUTHORIZATION
BULK WATER PURCHASE/WASTEWATER LAGOON DEPOSITS
Purchase of Bulk Water: $14.15 per M3 264.17 Gallons = 1 M3
This Request is made by:
Owner/Business Operator
Contractor
Address of Wastewater Pickup:
Date Deposited:
Amount Deposited (Gallons):
Number of Loads:
Total amount Deposited:
Pricing per load (based on volume delivered):
0-2000 Gallons = $100.00 per load
2000-5000 Gallons = $150.00 per load
5000+ Gallons = $250.00 per load
Total Cost:
Name of Owner/Contractor (please print): ____________________________________
Signature of Owner/Contractor: ____________________________________________
Information taken by (Town Staff name) ______________________________________