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Acknowledgement of Gas Tank Removal Fillable rev - 85-104 Alawa Pl, Waianae, HI 96792.pdf

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Removal of Tank Date: 08/19/2025 I Earl Co Full Name (homeowner) authorizes Hawaii Gas to remove the Gas Tank at the following premise location 85-104 Alawa Place, Waianae, HI 96792 Address Please initial the following request: EC I Will be returning to gas I authorize Hawaii Gas to complete the above request. I understand by choosing to remove the gas tank from my property I will be returning to gas. I understand if the tank is to be relocated I may be responsible the associated fees and cost a

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Removal of Tank

Date: 08/19/2025

I Earl Co
Full Name

(homeowner) authorizes Hawaii Gas to remove the Gas Tank at

the following premise location 85-104 Alawa Place, Waianae, HI 96792
Address
Please initial the following request:
EC

I Will be returning to gas

I authorize Hawaii Gas to complete the above request. I understand by choosing to remove the gas tank
from my property I will be returning to gas. I understand if the tank is to be relocated I may be
responsible the associated fees and cost as deemed by the sales representative following a site visit.
I Will NOT be returning to gas
I authorize Hawaii Gas to complete the above request. I understand by choosing to remove the tank
from my property I will be responsible for all associated fees and cost if I choose to reinstall the tank at a
later date.

By signing this form I agree to the above

Earl Co
Print Name

For Office Use Only

Signature

08/19/2025
Date

Date:
Gas Account Number:
Account Name:

1

Customer Service Rep:

Additional Information:
Point of Contact for Scheduling Removal:

Earl Co
Name: ____________________________________________
518-588-4428
Phone Number: _____________________________________
alawaplace@gmail.com
Email Address: ______________________________________
8/20/2025
Requested Removal Date: _____________________________
* Please note once we receive the request it may take up to 6-8 weeks from the date of receiving your
request to schedule the meter/line removal*

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