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Work Activity Work Order <br />ISSUOd By CSG CAVANAH,SHANE G. <br />Issued Department Pw PUBLIC WORKS <br />Date Issued 81112013 Pro ram »o Function >>� <br />Fund aot Accour.t 5 9 <br />Program REPAIR 75 1NCH 4811 GCFAN AVE 7107196i5 <br />Title <br />ZO'I3'ISO2 Pf0 @Ct Activity Type SERVICE REQUEST <br />Work Order No � <br />PagP 1 <br />3i21/2013 10:27 <br />Activity 6�5 <br />StaWs aivzois Time �s:�a Original WO __ __ ___ B�Iling __ <br />Customer Infonnation <br />Customer Name DICKENSON, siu <br />Address aa�� <br />Apartment No <br />State <br />Subdivision <br />Phone No ( azs ) aae-ss�z <br />Second Phone � 1 - <br />E-Mail Address <br />Problem Information <br />Address 4811 <br />From Cross Street <br />To Cross Street <br />City <br />Subdivision <br />Sif2Bl OCEAN AVE <br />City <br />z�r <br />Ext <br />Ext <br />Street OCEANAVE <br />Problem WATER WATER <br />Sub Problem LEAK LEAK <br />Requested By MBR MOSS. BRIAN R. <br />Agency <br />Initiated From PUBLIC PUBLIC <br />Utility Locate (USA) No <br />Assignment Information <br />Dept PW P�8=1C WORKS <br />Crew <br />Contractor <br />Assigned To csc <br />Assigned By <br />Assigned Date <br />Scheduled Date _ <br />Raute <br />Comments <br />Action Taken REPAIRED SERVICE. <br />Recommended Action <br />Map Book <br />Called Date <br />CAVANAH,SHANE G. <br />To Be Comp Date <br />Scheduled Time <br />Route Sequence <br />Customer ld <br />Change Map Y/N <br />Status c� <br />Zip <br />Map Reference <br />Da'e Requested eivzo�s <br />Related Request oo�zz�ea <br />Expiration Date <br />Priority Estimated Hours <br />Approved By Mwe MOORE. WARREN E JOb CCSt IflfOffn8tl0t7(Y/N) <br />Tirne Date Completed 81812013 Permit No <br />Sl3rt Date i � -- — - <br />Com�;leted By Time --_ - Follow Up? ____ <br />