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Work Activity Work Order Pa9e 1 <br /> iz/ze/zoii e:os <br /> ---__ — -- <br /> ISSl1Cd BY �AGA AHLES,GREGORY A. <br /> Issued Department Pw PUBLIC WORKS <br /> Date Issued �onzizota <br /> Fund ao� Account s Pro9ram »o Function to9 Activity e» <br /> Program <br /> Title REPAIR 3205 PACIFIC 710709677 <br /> Work Order No ZQ��Z3a7 P�OJOC[ Activity Type CORRECTIVE MAINTENANCE S�8fU5 Cl. <br /> Status �on2�zo�� Time u_ae Original WO __ Billing _____ — <br /> Customer Information <br /> Customer Name Customer ld <br /> Address 1205 Stf20t PACIFIC AVE <br /> Apartment No City <br /> State Z�P <br /> Subdivision Change Map Y!N <br /> Phone No ( ) - Ext __ _ <br /> Second Phone ( ) - Ext <br /> E 'Aail Address ___—_--- --.--- ------ <br /> Problem Information <br /> Address 3205 Street pqCIFIC AVE <br /> From Cross Slreet <br /> To Cross Street <br /> City Z�p <br /> Subdivision Map Book Map Reference <br /> Problem SEWER SEWER <br /> Sub Problem MANHOL MANHOLES <br /> Requested By Date Requested <br /> Agency <br /> Related Request <br /> Initiated From <br /> Utility Locate (USA) �Jo Called Date Expiration Date <br /> Assignment Infonnation <br /> Dept Pw PUBLIC WORKS Priority Estimated Hours <br /> CfBW SCONST SEWER CONSTRUCTION(AHLES) <br /> Contractor <br /> Assigned To oes OLHAVA,BRAD S. <br /> Assigned By AGA AHIES,GREGORY A. <br /> Assigned Date ___ _ To Be Comp Date <br /> Scheduled Date ___ Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Taken BOLTED RING AND LID TO M.H. <br /> RCCOtllfll@IldBd ACi1011 STRAP RING AND LID TO MH SECTION <br /> Approved By oes o�HnvA,BRAD s. Job Cost Information(YIN) <br /> Start Date i I Time _ ____. Date Completed �onanott Permit No <br /> Completed By _ ___ Time __ Follow Up7 <br /> _ � <br />