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eacc '- <br /> VVork Activity Work Order �,��,,�,; i3:;� <br /> - -- - -- <br /> ISSU2d BY � SMA1� SCALZO,MELODY A. <br /> Issued DepartmentPw PUBLICWORKS <br /> Date Issued aixano�a Function AcEviry <br /> Fur.d aoti Account 5 Program <br /> Program U73473 a a <br /> TIflO CONVERT J5 INCH 2227 LOMBARD AVE UT3473-4-3 <br /> Worl< Order No 20140987 PfOJ2Ct Activity Type CORRECTIVE P.MINTENANCE St2tU5 CL <br /> Status aizanein Time �tie OriginalWO_____ __ (3illing _ - ---- <br /> Customer Information Customer ld <br /> Cusromer Name <br /> Address Str�et <br /> ,4partment No City <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No ( ) - Ext _._.—.-- --- - <br /> Second Phane ( ) - Ext <br /> E-Mail Address ----- — ---- ---- -- <br /> ,'roblem Information <br /> A�idress 2PY7 Street LOMBARD AVE <br /> I-rom Cross Street <br /> To Cross Street Zip <br /> City Map Book Map Reference <br /> Subdivision <br /> Problem WATER WATER <br /> Sub Problem OTHER OTHER Date Requested <br /> Requested By Relat=d Request <br /> Agency <br /> Initiated From Ex iration Date <br /> Utility Locate (USA) No Called �ate P <br /> Assignment Information <br /> Dept Priority Estimated Hours <br /> Crew <br /> � Contractor <br /> Assigned To <br /> Assigned By To Be Comp Date <br /> �� Assigned Date _ -- ----- �, , , <br /> Scheduled Date __ Scheduled Time ___ �� <br /> Route Route Sequence <br /> Comments <br /> Action Taken CONVERT.751NCH CUFidSTOP TO.751NCH SETTER WITH METER AND BOX.FLAT TO METER <br /> PROJECT <br /> Recommended Action <br /> Job Cost Information(Y/N) <br /> Approved By HLJ HUSBY,�NCE J. — Pefflllt �JO <br /> - - --- Date Completed snaizo�a ___ <br /> Start Date � i Time ----- - <br /> Campleted [�y Time Follow Up? <br /> _ __.._. <br /> --- --..,;� - --- ------- <br />