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Work Activity Work Order Pa�� ' <br /> i;ze/za:s ic.ze <br /> _ _ _ _ -- — _ — - - -- <br /> ISSUCd By OBS OLNAVA,BfUD S. <br /> Issued Department Pw PUBLIC WORKS <br /> Datelssued saniots <br /> Fund �ot Account s Program »o Function t�a Actrvity 6» <br /> Program <br /> T�tle RFPAIR 1625 CHESTNUi ST 71012367J <br /> Work Order No 20151210 Pro�ect Act�wty Type SERVIC[ HEOUf:ST Status c� <br /> Status srz�r2oi5 Time oe a+ Ongmal WU Bdl�ng _ _ i <br /> Customcr Information <br /> Cuslomer Name Customer ld <br /> Address Street <br /> Apartment No Gty <br /> State Z�P <br /> Subdrvision Change Map YIN <br /> Phone No i � - Ext <br /> S?cond Phone t 1 � Ext - - <br /> E-Mail Address <br /> Problem Irlormation <br /> Add�ess �6p5 Sireet CHESTNUT ST <br /> From Cross Sireet <br /> To Cross Street <br /> City Zip <br /> Subdiws�on Map Book Map Relerence <br /> Problem DRAIN DRA/NAGE <br /> Sub Problem DL DRAIN L/NES <br /> Requested By oes OI HAVA BRAD S Date Requested vnno�s <br /> Agency Related Request oo�a�e�9 <br /> Iniliated From ADMIN ADMINISTRAtiON <br /> UUlity Locate (USA) No �siu�u Called Date ExpuaUon Dale <br /> Assignment Informatlon <br /> Depl PW PUOUC WORKS Pnonty Estimated Hours <br /> CfCw SCONST SEWfRCONSTRUC710N10lFIAVA) <br /> Contractor <br /> Assigned To ��M ItdMOf. JAMES M <br /> Assigned Dy ODS OIHAVA BRAD S <br /> Assigned Date __. Tc Be Comp Date <br /> Scheduled Date Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Taken REPAIRED 14"CMP-REPLACED 6'W/12"PVC. BACKFILLED WIGRAVEL,COMPACTFD, <br /> SEEDED. <br /> Recommended Action REPAIR DRAIN LINE <br /> Approved By IJM IMHOF,JAMES M Job Cost Inlormation(YIN) <br /> - _ - — <br /> Slart Date i i Time Date CompleteA s�aeizo�5 Perm�t No <br /> - - _ _ _ _- - <br /> Comp�eted By Time Fotlow Up� <br />