Castle Rock Free Quote
Mains Gas Supply
Client Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
E-mail
*
example@example.com
Correspondence Address
*
Street Address
Street Address Line 2
Town
City
Post Code
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New customer.
*
Property Type
*
Domestic
Commercial
Best Time To Call
*
Morning
Between 12pm -3pm
Between 3pm - 7pm
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Job Title
CONNECTION OPTIONS
*
Please Select
New Gas Connection
Gas service Alteration
Gas service Disconnection
Commercial Connection
Multiple connections
Upgrade service
Downgrade service
Job Description / works Required
*
Site Details / Site Address
*
Site Post Code
*
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Site contact
*
First Name
Last Name
Site Address
*
Street Address
Street Address Line 2
Town
City
Postal code
Correspondents Address Same As Site Details
*
Yes
No
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Number Of Plots / Units
*
Date Connection Required
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Works required
*
New Gas connection
Multiple new connections
Disconnection
Alteration
Metrebox Type
*
Wall Mounted
Recessed Box
In Ground
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Select existing meter box
*
Surface Mounted Box
Built in Recessed Box
Semi Concealed Ground Box
Internal / No Box
NA - New Connection Only
Do You Require a Quotation For Excavations On Site?
*
Yes
No Cuztomer To Dig Own Trench
Is the property in a conservation area?
*
yes
No
Who will re-route the internal gas pipework between the new meter position and the gas boiler?
*
Castlerock Gas
Own Gas Engineer
Do you want castlerock gas to move the meter?
*
Yes
No i'll use my own gas engineer
Is the property a listed building?
*
YES
NO
Please Upload Site Related Documents Location Data / Site plan
Browse Files
Drag and drop files here
Choose a file
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of
Predicted Gas Usage KW Per Plot
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Declaration
I confirm the information provided is correct and I agree to the application details above.
Name
*
First Name
Last Name
Signature
*
Submit
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