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- - . ., ci� r ur.tvertt i i <br /> . . <br /> ;.i,..R�:..r: .. DEPARTMENT OF PUBLIC WORKS , i.'u—� - _�-�`% ': <br /> a�."' -e-- � - - •. �ti .. . - . � .� . -. . - � � - <br /> . -. UTILITIES DIVISION ,. :� - .. <br /> _ ,: , _ � .. :. ... .,, .-> ... ..:.. . . W.O. No. : .. . , ' <br /> _ _ _ . <br /> . 1 J . . . � . .. . . . 1 . . � ' . . , • <br /> ... . : ��29�,y Acct No � ' , <br /> ._ � ,_..._� r. .�._ 3 - �-7 Y 9 <br /> - -. __ . --�- - -. - . . . . , _ <br /> -. .:. . . :' _ _ �2/� PcsT"E� Complaint No :. ._ . .. <br /> ' UTILITY WORK ORDER '''o T�'`"'+`n5 - <br /> _ _ _ __. . . _. .. . _ .. _:,, _ . <br /> .Date: " 7 Z S "d'y �WATER ,I�SERVICE `I�MAINTENANCE � : <br /> � <br /> ... � � SEWER ❑ MAIN � OPERATION <br /> - �--• �• � � O STORM ❑ PUMPSTATION ❑ REPAIR -;•- <br /> .• ❑ TREATMENT ❑ CONSTRUCTION <br /> ❑ RESERVOIR ' <br /> ❑ VALVE <br /> ❑ MAN HOLE <br /> . ❑ CATCH BASIN <br /> ❑ DITCH • <br /> Location: � �2 r E/f'l L �� ��J . <br /> W.O. Instructions: �•y�'��t � � S ji+PY� �.< �v�? j t.i'f��.l •�'f ✓ S� <br /> i <br /> ESTIMATED : ACTUAL �5 -(— <br /> ` Labor(hours) . Labor(hours) . <br /> . . . Material (cost) . Material (cost) . <br /> Equipment (cost) : Equipment (cost) : <br /> SCHEDULING REQUESTED <br /> USE CHARGE ACCOUNT NUMBER BELOW FOR LABOR TIME SLIPS. ITEMIZE <br /> LABOR, EQUIPMENT, AND MATERIALS ON REVERSE Slf?E. � <br /> 'Completion (Date): _ 7' ����9 Cost:$ <br /> � Charge Account Number. Charge Cost To(Name): <br /> :Address: Zip: <br /> Invoice No.: Amount:$ Date: <br /> 1/NS � . . . . . <br />