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Work Activity Work Order fd-� � <br /> i:%,e/��.;s ii :c, <br /> ISSU2d By HLJ NUSBY,LANCE J. <br /> Issued Departmentaw PUBLICWORKS <br /> Date Issued �v3rzo�s <br /> Fund sot Account s Program Function Activity <br /> Program ursa�a e a <br /> TIiIE CONVERT 751NCH 909 PAGIFIC AVE UT3473-8-3 <br /> WOfM Ofd2f NO ZO�SY4YO PfOJBCt AcGwty Type CORRECTIVE MAiNTENANCE SI3fU5 CL <br /> Status �iiarzo�s Time �ca� Ongmal WO Bill�ng <br /> Customer Infortnation <br /> Customer Name Customer ld <br /> Address Sireet <br /> Apartment No City <br /> State Z�p <br /> Subdwision Change h7ap Y/N <br /> Phone No � 1 • Exl <br /> Secand Phone ( 1 - Exl - - - - - - <br /> E-Mad Address <br /> Problem Intormation <br /> Address gpg Street pACIFIC AVE <br /> From Cross Street <br /> To Cross Street <br /> City ---- Z P <br /> Subdwlsion Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OTHER <br /> Requested By Date Requested <br /> Agency Related Request <br /> Indiated From <br /> UGlity Locate �USA) No Called Date Expiration Oate <br /> Aasignment Information <br /> Dept Pnonty Est�mated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By ` j r -' , y�l ;" ; , <br /> Assigned Date To De Comp Date � ? ' ""' ' <br /> Scheduied Date Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Taken CONVERT 351NCH CCRBSTOP TO.751NCH SETTER WITH METER AND JUMPER FLAT TO <br /> METERPROGRAM. <br /> Recommended Action <br /> Approved By wo� wenvER o[nN � Job Cost Information(Y/N) <br /> Start Date i i Time Date Completed �v�no�s Permit No <br /> Completed By Time Fo�low Up� <br />