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<br /> }:" �r :c; �r „ . • •�e.w`�" ' UTILITIES DIViSION t s?.,�� '.a w�- � ; t ��"�':�
<br /> - .i;� s�;:, W.O. No. ` " .
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<br /> UTILITY WORK ORDER ' � � I `�"�( ,: `+� �,;. ' . : ,.
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<br /> Date: ' ` ! [�. WATER ,�'�"'O SERVICE ' O MAINTENANCE" *'y '°�
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<br /> • , , - '. ❑ SEWER � MAIN . � ❑ �OPERATION � ,
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<br /> ' � " �' � ❑ STORM ❑ PUMP STATION ❑ REPAIR _ h �% �:
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<br /> �;r ❑ TREATMENT � CONSTRUCTION , ,,, : �"' "
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<br />' . . ❑ VALVE
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<br /> ❑ CATCH BASIN -
<br /> ❑ DITCH .
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<br /> Location:
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<br /> W.O. (nstructions: �1/L'�1JA�F M A��e' o� /�e� //}� ''" ti�✓AL �o�✓✓�TO-�
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<br /> ESTIMATED ACTUAL ,
<br /> �abor(hours) . Labor(hours) .
<br /> Mzterial (cost) , . Materiai (cost) . .
<br /> Eguipment (cost� : Equipment (cost) :
<br /> SChEDULING_REQUESTED � y
<br /> USE CHARGE ACCOUNT NL�MBER BEI.OW FOR LA30R TIME.SLIPS:-ITEMIZEC :. , s;;: , I
<br /> LABOR EOUIPMENT, AND MATERIAI_S ON REVERS,cS,IDE ,.� ��•,, jti, �
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<br /> . Completion (Date): 3 � 3 ' � / Costa � ' ,
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<br /> Charge Account Number. �Charge Cost To(Name).
<br /> Aadress:' . u• �� �T - - '. Zip:.
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<br /> InvoicA No.: Amount:$ Date:
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