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Work Ac�ivity Work Order Pege i <br /> 6/19/2014 8:36 <br />. _ __ ______--_ _____'—____—__—_____ ______-____ <br /> ISSUEd B;� SMA1 SCALZO, MELODY A. <br /> Issued Department Pw pUBLIC WORKS <br /> Date Issued 5nno�q <br /> Fund ao� Account , Program Function Activity <br /> Program UTJ4'J3 a a <br /> TIflO CONVERT.751NCH 19161OMBARO AVE UT3473�i3 <br /> WOfk Ofd2f NO 20141106 PfOj2C� Activity Type CORRECTIVE MAINTENANCE SI2f115 CL <br /> Status sm2oia Time_�i:se Original WO Billing _ <br /> Customcr Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartmeni No City <br /> State Zip <br /> Subdivision Change Map YIN <br /> Phone No ( ) • Ext <br /> Second Fhone ( ) - Ext - — <br /> E-Mail Address <br /> Probiem :nformation <br /> Address �g�6 Street LOMBARD AVE <br /> From Cross Street <br /> To Cross Street <br /> City Zip <br /> Subdivision Map E3ook Map Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OTHER <br /> Requested By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Utilir/ Locate (USA) No Called Date Expiration Date <br /> Assignment Information <br /> Dept Priority Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assigned Date _ __ To Be Comp Date _ <br /> Scheduled Date __ Scheduletl Time � �':�'� '''�'�'��li ' �J _' , � <br /> Route Route Sequence <br /> Comments <br /> Action Taken CONVERT.7514CH CURBSTOP T0.751NCH SETTER WITH METER AND BOX. FL1�T TO METER <br /> PROJECT. <br /> Recommended Action <br /> �tpproved By HLJ HUSBY, IANCE J. JDb COSf Ift(OffT10f10�(Y/N) <br /> Start Date i � Time Date Completed srzenota Permit No <br /> -- -- - _— -- ------- --- — <br /> Completed By Time Follow Up? <br />