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i <br /> � • • . �++ t � 'yfZ..0 C'T�ui� �iiV:41 y�Y����}�+�r-� J r>�.t,� .a::: ;r �. ^ • �'?:lYi�:i «. �,�. . <br /> •:�z .'�€:`�.'r,?x;: �ril,i c;R�`i�`in{r-1.htc�"'�fi'w'rKlo•�iY('#�r�a��:s�i?i L� .� l�a�`t F'd�1����,.•:. <br /> '€ . <br /> ' -' CITY OF EVEREIT . ' ' ` ' <br /> .� � '_. <br /> • + � _',F ' . . . DEPARTMENT OF PUBLIC WORKS � �.=- •• •• ��•5 ' <br /> � ' UTIUTIES DIVISION <br /> W.O. No. �� <br /> . ���A�t-� V Acct No. L�T i 1 y .. <br /> _. : . . ;. . � <br /> UTILITY WORK ORDER Comp la in t No. <br /> Date: �� �� � �' � WATER i� SERVICE �] MAINTENANCE <br /> ❑ SEWER ❑ W1AIN O OPERATION <br /> ❑ STORM ❑ PUMP STATION ❑ REPAIR <br /> ❑ TREATMENT ❑ CONSTRUCTION <br /> ❑ RESERVOIR <br /> ❑ VALVE <br /> ❑ MAN HOLE <br /> ❑ CATCH BASIN <br /> ❑ DITCH <br /> 5 .(J 1�1111�: •C. l� �-->>I! // <br /> Location: <br /> ) ot nJZ.. cr t L �.� < �:.. 'r �� ..��3 i?c1( <br /> W.O. instructions: <br /> ESTIMATED ACTUAL <br /> Labor(hours) . Labor(hours) . <br /> Material (cost) . Material(cost) . <br /> Equipment (cost) : Equipment (cost) : <br /> SCHEDULING REQUESTED <br /> USE CHARGE ACCOUNT NUMBER BELOW FOR LABOR TIME SIIPS. ITEMIZE <br /> LABOR, EQUIPMENT, AND MATERIALS ON REVERSE SIDE. . <br /> Completion (Date): ��'� �'��J Cost:$ <br /> Charge Account Number: Charge Cost To (Name): <br /> � <br /> Address: Zip:. <br /> Invoice No.: Amount:$ Date: <br /> .95 � <br />