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Work Activity Work Order Pa9c 1 <br /> 9/3/2015 B:Sd <br /> _ ____ _ _.._._. __.... __— <br /> ISSUCd By WDL WEAVER,DEAN L. <br /> Issued DepaRmentPw PUBLICWORKS <br /> Date Issued eieizo�s <br /> Fund aoi Account s Program Function Aclivity <br /> P;ogram UT3477 s � <br /> TifIC CONVERT.75 INCH 1730 ROCKEFELLER AV[UT3473�6-3 <br /> Work Order No 20151764 Project Activity Type CORRECTIVC-MAINTEN�NCE Status c� <br /> Slalus B/6f2015 Time i5:ie OriginalWO _ Billing _ ___ _ ______ <br /> Customer Intormation <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No ( 1 - Ext <br /> Second Phone ( 1 - Ext -- -- <br /> E-Mail Address ___ _ __. __ <br /> Problem Information <br /> Address 173p Street RUCKE�FLLER AVF <br /> From Cross Street <br /> To Cross Street <br /> City Zip <br /> Subdivision Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OTHER <br /> Requested By Date Requested <br /> Agency Related Request <br /> Imtiated From <br /> Utility Locate (USA) No Called Dat� Expiration Date <br /> Assignment Information <br /> Dept Prionty Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By To Be Comp Dale �`,i;�;`��`�' - ; •• �..,, ,_;� -, <br /> AssignedDate _ __ _ ��1;��.-:;1� <br /> � � 1 .\.�i.'..��.�: �i�. <br /> Scheduled Date Scheduled Time <br /> Route Roufe Sequence <br /> Comments <br /> Action Taken COtIVERT.75 INCH CURDSTOP T0.751NCH SETTER MET[R AND 80X.FLAT TO METER <br /> PROGRAM. <br /> Recommended Action <br /> AppfOvOd By EAL ERICKSON, ANDR[W L. JOb COSI Ifl(Oft1l2GOf1(Y/N) __ <br /> Slart Date i i Time __ _ Date Completed e��mzo�s Permit No _ <br /> Co�npleted [3y Time Follow Up7 <br />