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�/ <br /> Work Activity Work Order � �� ' <br /> ,, . , ,: � <br /> ISSUBd By CAG CRUM,GERRV <br /> Issued Department Pw PUBLIC WORKS <br /> Date Issued �onv�oo� <br /> Fund aot Accounl s Program »o Function i�s Activity e» <br /> Program <br /> TIfIC TAP B INCH 1110 CHESTNUT ST 710119677 <br /> WOfk OfdBf NO 20���97� PfO�CCt Activity Type CORRECTIVE MAINTENANCE S18�U5 PR <br /> Date torzznoo� Timc ta ze Original WO zoo�os�t Billing <br /> Customer Information <br />, Customer Name Customer ld <br /> Address Stroel <br /> Apartment No City <br /> State Zip <br /> Subdivision Change Map Y/N <br /> Phnne No ( 1 - Ext <br /> Second Phone 1 ) - Ext <br /> E-Mail Address <br /> Problem Information <br /> Address ���p Slreet CHESTNUTST <br /> From Cross Slreet <br /> TO CfOSS SIfEP� <br /> C1�Y _ — Z�� <br /> Subdivision Map Book Map Reference <br /> Problem <br /> Sub Problem <br /> Req��ested By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Utility Locate (USA)No Called Dato Expiralion Date <br /> Assignment Information <br /> Dept Priority Eslimated Hours <br /> Crew <br /> Coniractor <br /> Assic�ned To <br /> Assigned �y <br /> Assigned Date To Bo Comp Date <br /> Scliedulod Date Scheduled Time <br /> Roule Roule Sequence <br /> Commants at ea��.:� <br /> Action Taken <br /> � <br />