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<br /> UTILITY WORK ORDER ` ' " , '
<br /> _ . . , ... . . _. . ; i . .' :
<br /> Date: ��� �O WATER � ❑ SERVICE ❑ MAINTENANCE ' ' . .
<br /> � ❑ SEWER O MAIN O OPERATION :
<br /> -�Y_STORM ❑ PUMP STATION O REPAIR
<br /> ❑ TREATMENT ��ONSTRUCTION
<br /> ❑ RESERVOIR
<br /> ❑ VAIVE
<br /> ❑ MAN HOLE
<br /> ❑ CATCH BASIN
<br /> �y�DISCH
<br /> Location: ,��/.� �����r/�,�,Z�
<br /> W.O. I�structions: �,1[%�.1� /� �� � �///� �/.UE �
<br /> ,
<br /> ESTIMATED ACTUAL
<br /> i
<br /> Labor(hours) . tabor(hours) . _ _
<br /> Material (cost) . _ Material (cost) .
<br /> Equipment (cost) ; Equipment (cosq :
<br /> ,
<br /> � , . _. _ _
<br /> SCHEDULING REOUESTED . .
<br /> USE CHARGE P,CCOUNT NUMBER BELOW FOR LABOR TIME SLIPS. ITEMIZE ` ��: '`'' '
<br /> LABOR, EOUIPMENT, AND MATERIALS ON REVERSE SIDE. , , ,
<br /> __. ._. . L ,
<br /> Completion (Date): q"�—��/ Cost:S
<br /> Charge Account Number. Charge Cost To(Name):
<br /> . .j1:�,."�`5`:i� :: ' . . . �
<br /> Address s , ,. .•o ` Zip:
<br /> ;,
<br /> ...., ,:A; SSr Date: .
<br /> Invoice No.: ' '� i'x '� AmounL•$ --
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<br /> �: AS . � . . . ,
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