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Work Activity Work Order � �. <br /> ISSUed BY SJT2 SPOONER,JAMES T. <br /> Issued Department PW PU�LIC WORKS <br /> Date Issued tnuzoto <br /> Fund qo� Account 5 Prograrn �io Function >>9 Activiry c�s <br /> Program <br /> TitlB REPAIR]S INCH 1622 PALhi AVE 7701196i5 <br /> WOfk OfdOf NO 2O'IOOZOZ PfOJeCf Activity Type CORRECTIVE h1i+INTENANCE S?dlUS CL <br /> Stalus v2vzoio Time ta:st Origin2l WO_ _ _ _ Billing <br /> Customer Information <br /> Cuslomer Name Custonter ld <br /> Address Street <br /> Apartment No City <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No ( i - Ext <br /> Second Phone 1 ) • Ext <br /> E-Mail Address <br /> Problem Information <br /> Address �gyy Stieet pqLMAVE <br /> From Cross Street <br /> To Cross Streel <br /> City Zip <br /> Subdivision F.tap Book F.1ap Reference <br /> Problem WATER WATER <br /> Sub Problem LEAK LEAK <br /> Requested By Dale ReGuested <br /> Agency Related Request <br /> Initiated From <br /> Utility Locate (USA) No Called Date Expiration Date <br /> Assignm�:nt Information <br /> pept Priarity Estimaled Hours <br /> Crew <br /> Conlractor <br /> Assigned To <br /> Assigned By <br /> Assigned Uate To Be Comp Date <br /> Srheduled Date Scheduled Time _ _ <br /> Route Route Sequence <br /> Comments <br /> ACIiOn Takefl .751NCH POLY FROM PREVIOUS REPAIR WAS LEANING. PUT IN NEW.75 INCH POLY. <br /> Rocommended Action <br /> Approved 8y Wo� wEnvER,oenN�. Job Cost Information(Y/N) <br /> S(�rt Date I ! Time _ Date Completed �nv2oto Permit No <br /> Completed By _ — -- - Time Follow Up?_ -- <br /> /� <br /> �''Z� <br /> ,� <br />