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Work Activi#y Work Order <br />Page 1 <br />9/28;2014 11:96 <br />ISSUed BY CSG CAVANAH, SHANE G. <br />Issued Department Pw PUBLIC WORKS <br />Date Issued sieno�a <br />Fund ao� Accou�t s Program �to Function ris Activity 675 <br />Frogram <br />Tit�e REPAIR 75 INCH 7533 LOWER RIDGE RD 7707 79675 <br />Work Order No 20141121 PfOfOCt Activiry Type CORRECTIVE MAINTENANCE <br />Status 5�enoia Time �5:55 Original WO zoi3o9oa ____ Billing_ __ _ __ <br />Customer InSormation <br />Customer Name <br />Address <br />Apartment No <br />State <br />Subdivision <br />Phone No � 1 - <br />Second Phone f > - <br />E-Mail Address <br />Problem Information <br />Address <br />From Cross Street <br />To Cross Slreet <br />City <br />Subdivision <br />Problem <br />Sub Problem <br />Requested By <br />Agency <br />Initiated From <br />Utiliry Locate (USA) No <br />Assignment Information <br />Dept <br />Crew <br />Contractor <br />Assigned To <br />Assigned By <br />Assigned Date <br />Scheduied Date _,____ _ <br />Route <br />Comments <br />Street <br />City <br />Zip <br />Ext <br />Ext <br />Street <br />Map Book <br />Called Date <br />To Be Comp Date <br />Scheduled Time <br />Route Sequence <br />Action Taken RETAPPED SERVICE ON 6 INCH DUCTILE IRON. <br />Recommended Action <br />Customer ld <br />Change Map Y/N <br />Zip <br />Map Reference <br />Date Requested <br />Related Request <br />Expiration Gate <br />Priority Estimated Hours <br />$f8tU5 CL <br />Approved By MWE MOORE, WARREN E. JOb COSf �flfOffT12tI0f1(YJN) _ <br />Start Date � � Time Date Completed snzizo�a _ Perrnit No_ <br />Completed By__ Time _ Follow Up? _____ <br />