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Work Activity Work Order Pa9e 1 <br /> 7/ZB/2015 10:44 <br /> ISSUed By OBS OLHAVA,BRAD S. <br /> Issued DepartmentPw PUBL�CWORHS <br /> Oate Issued siseizo�s <br /> Fund aot Account 5 Progrem �to Function �oe Aclivity 6�5 <br /> Program <br /> Title RE-PAIR 2318 PINE ST 710109G75 <br /> WO�k OfdOf NO 20151213 PfOJECi Activity Type SERVIC[R[�UEST S18�U5 CL <br /> Status sizerzois Time �3:s� Original WO &Iling __ <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> State ZiP <br /> Subdivision Change Map Y/N <br /> Phone No ( ) • Ext <br /> Second Phone ( 1 - Ext ' <br /> E•Mail Address <br /> Problem Information <br /> Address Y318 Street p�NE ST <br /> From Cross Street <br /> To Cross Street <br /> City Z�P <br /> Subdivision Map Book Map Reference <br /> Prnblem SEWER SEWER <br /> Sub Problem SS SIDE SEWER <br /> Requested By oes o�Hnvn,etuo s Date Requested 512612015 <br /> Agency Related Request oo�e�osi <br /> Initiated From OCD OTHER CITY�EPARTMENTS <br /> Utility Locate (USA) No 15151189 Called Date Expiration Date <br /> Assignment Information <br /> Dept Pw PU�I IC WORKS Prioriry Estimated Hours <br /> CfeW SCONST S[WERCONSTRUCTION(OLHAVA) <br /> Contractor <br /> Assigned To PH1R PUGSLEY.WILLIAM1I R <br /> Assigned By oes OLHAVA,BRAD S <br /> Assigned Date _ To Be Comp Date <br /> Scheduled Date Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Taken REPLACED STAND PIPE WITH 6"PVC 6 FEET�EEP REPLACED Si5 WITFi 6"PVC 14 FT TO <br /> PROP LINE WITH BACKWATER VALVE. <br /> Reccmmended Action REPAIR SIDE SEWER <br /> Approved By PWR PUGSLEY.WILLIAM R JOb COSI Ifl(0�I110f10f1(Y/N) <br /> Start Date � � Time Date Completed 6I21I015 Permit No <br /> Compieted f3y Time Follow Up? <br />