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�� �������� �: <br />Work Activity W�rk Order Pd4e 1 <br />9/21/2013 B:O1 <br />ISSUBd BY � CSG � CAVANAH,SHANE G. <br />Issued Departmentaw PUBLICWORKS <br />Date Issued 611 012 0 1 3 <br />Fund aot Account 5 Program »o Function »y Activi!y s7s <br />Program <br />Title REPAIR .75 5630 LOWELL RD 710119675 <br />Work Order No 20131213 Project Aciivity Type SERVICE REOUEST Status c� <br />Siatus 5I10�2013 Time is2� Original WO Bilfn _________ ____ ____.. <br />— _ ___9 __ <br />Customer In!ormation <br />Customer Name LARSON, STEVE <br />Address 5619 $ifEEt LOWELL RD <br />Apartment No City <br />State Z�P <br />Subdivision <br />Phone No ( a2s ) 353•T913 Ext <br />Second Phone l ) • Ext <br />E-Maii Address <br />Problem Information <br />Address 5630 Street LOWELL RD <br />From Cross Street <br />To Cross Street <br />City <br />Subdivision Map Book <br />Problem LYATER WATER <br />Sub Problem LEAK LEAK <br />Requested By GGW GRAVES. GARY W. <br />Aqency <br />Ir�itiated From PUBLIC PUBLIC <br />Utilitv Locate (USA) No Called Date <br />Assignment Information <br />Dept FW PUBLIC WORKS <br />Crew <br />Contractor <br />Assigned To CSG CAVANAH, SHANE G. <br />Assigned By <br />Assigned Date __ _. _ To Be Comp Date <br />Scheduled Date ___ _. Scheduled Time _ <br />Route Route Sequence <br />Comments <br />Action Taken LEAKING AT UNION AT CORP. REPLACED COPPER RING. <br />Recommended Action <br />AppfOvOd By MWE MOORE, WARREN E. <br />____ _ <br />Start Date i i Time <br />Completed By ___ <br />Customer ld <br />Change Map Y/N <br />Zip <br />Map Refe ence <br />Dat2 Requested 6/9/2013 <br />Reiated Request oo�zoaes <br />Expiration Date <br />Priority Estimated Hours <br />Job Costlnformation(Y/N) <br />Date Completed enzizo�a_ ___ Permit No__ <br />Time Foilow Up? ------__— <br />