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Notice of Intent to Perform Fumigation Close / Restore

Fumigation Company / Contractor Information  ? 



For questions regarding a gas odor or carbon monoxide please call us immediately at 1-800-427-2200
Do not use this form to report an emergency.
  * Indicates required field
Fumigation Company List *  
Fumigation Company Name *  
Contact Person *  
Telephone Number *       Extension    
Email Address *
  Alternate Contact Information
Alternate Contact
Alternate Telephone Number       Extension    
Alternate Email Address  

Customer / Premises Information  ? 



Close :(AM = 7:00 AM to 11:30 AM) (PM = 12:00 PM to 5:00 PM)(AD = All Day 7:00 AM - 8:00 PM)Cancellation:
Restore : (AM = 7:00 AM to 12:00 PM) (PM = 12:00 PM to 8:00 PM)(AD = All Day 7:00 AM - 8:00 PM)To cancel same day orders,
Saturday Restore : (After 10:00 AM) please call (800) 427-2200

    Customer Name   Apt. or Order Close Order Restore Order Total    
    Last, First Name Service * Space Schedule Schedule Schedule # of Access Code Type Code
    Business Name Address Fraction Cancel Date Time Date Time Mtrs. Arrangements  

Additional Access / Address Information - Please enter pertinent information only. Any additional text, such as “Please Cancel” or “Thank you”, may delay the processing of your order.
Additional Access / Address Information :

Terms & Conditions  ? 



Declaration Statement: I state that the information I have provided on this form is true and correct. Fumigation contractors are responsible for ensuring utility company has proper meter access to complete the order(s) requested. Restores require meter access and access into each home/unit/building in order to service gas appliances. Inability to access the gas meter (e.g., locked gates, dogs, etc.) and/or appliances will result in a delay and/or cancellation of your order. If a request is made to cancel an existing fumigation close order, the corresponding fumigation Back-On order, if any, will be automatically cancelled.