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ISSUBd By CAG <br />Issued Departmenl aw <br />Date Issued �tns�soos <br />Fund qo� <br />Program <br />Work Activity Work Order <br />CRUM,GERRY <br />PUBLIC WORKS <br />� <br />Page 1 <br />2/2�/2005 10:5P <br />Account s Program »o Function t1s Activity esq <br />TifIB 50 1 INCH 6715 MCDOUGALL AVE A8B 710179664 <br />WOfk Ofd@� NO 2�05���� PfOJ@CI Activily Type CORRECTIVE MAINTENANCE SfelUS CL <br />Date �vi5izoos Timei2:as Original WO t�ats Billing <br />Customer Information <br />Customer Name <br />Address <br />Apartment No <br />State <br />Subdivision <br />Phone No ( l <br />Second Phane l 1 <br />E-Mail Address <br />Problem Information <br />Address 6115 <br />From Cross Street <br />To Cross Streel <br />City <br />Subdivision <br />Problem <br />Sub Problem <br />Requested By <br />Agency <br />Initialed From <br />Utility Locate (USA) No <br />Assignment Information <br />Dept <br />Crew <br />CoMractor <br />Assigned To <br />Assigned By <br />Assigned Date <br />Scheduled Date <br />R�ute <br />Comments <br />Street <br />City <br />Zip <br />Ext <br />Ext <br />Street MCDOUGALL AVE <br />Map Book <br />Called Date <br />To Be Comp Date <br />Scheduled Time <br />Route Sequence <br />Action Taken NW CORNER: 18' LEFT OP LEFT AND 24' OUT. <br />Completed By KTJ <br />Start Dale r <br />Approved By <br />KELSO,THOMASJ. <br />� Time <br />Customer ld <br />Change Map Y/N <br />Zip <br />Map Reference <br />Date Requested <br />Related Request <br />Expiration Date <br />Priority Estimated Hours <br />Job Cost Ime�mation(YIN) <br />Date Completed ���11zoos <br />Follow Up? Permit No <br />Time <br />Problem Details � <br />a <br />