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NO ��ATERIA�S <br /> Work Activity Wur� Order page 1 <br /> 4�Z��zo�z ii:i� <br /> ISSU2d BY AGA � AHLES,GREGORY A. <br /> Issued Department Pw PUBLIC WORKS <br /> Datelssued vavzo�z <br /> Fund aot Account s Program ��o Function iza Activity 6�� <br /> Program <br /> TiNe SPII.L 2019 JEFFERSON PL 770123ti77 <br /> VJork Order No �O�,YOZJO PfOfECt Ac�ivity Type CORRECTIVE�dAINTENANCE S18W5 CL <br /> Status _ 2n!zci2___ :�ime is2e _Original W0 ___ Billing _ _ <br /> Customer Information <br /> Customer Name Customer ld <br /> AddfBSS 2019 StfB2tJEFFERSON PL <br /> Apartment No City <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No ( ) - Ext <br /> Second Phone ( ) - Ext — <br /> E-Mail Address <br /> Problem Information , <br /> Address yp�g Str�et �EFFERSON PL <br /> From Cross Street <br /> To Cross Street <br /> City Z�P <br /> Subdivision Map f3ook h9ap Reference <br /> Problem DRAIN DRAINAGE <br /> Sub Prablem SPILL SPILLS <br /> Requested By wee WHITNER, BARRIE B. D8f8 R2qU05fed vsvzo�2 <br /> Hy��cy Related Request <br /> Initiated From <br /> Utility Locate;USA) No Called Date Expiration Date <br /> Assignment Information <br /> Dept Pw PUBLIC WORKS Priority Estimated Hour <br /> Cf2W VACTV VACTORlN CREW(STECHER) <br /> Contractor <br /> ASS19f12d TO GCR GRENZNER,CHRIS R. <br /> A�signed By AC+A AHLES,GREGORY A. <br /> Assigned Date _ To Be Comp Date <br /> Scheduled Date Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Taken pUT O'.1T SOCKS AND ABSORBANT,CONTAINED SPREAD OF SPILL ANO CLEANED UP CB <br /> Recommended Action <br /> Approved By AGA AHLES,GREGORY A. JOb COSf IflfOffTlBtlOf1(Y/N) <br /> Start Date � � Time Date Completed v3�not2 ___ Permit No _ <br /> - - - - — — <br /> Compleled By _ _ _ Time _ Follow Up7__ _ _ _ __ <br />