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Work Activity Work Order <br />ISSUCd By HLJ HUSBY, LANCE J <br />Issued Departmen[aw PUBL�C WORKS <br />faqr 1 <br />,�r.a���,�� „_�4 <br />Date Issued �oiso�zots <br />Fund aot Account 5 Prog:am Function Actiwty <br />Program UTJ473 8 3 <br />TIUO CONVERT S INCH 1110 WALI ST UT'_d73-8-3 <br />Work Order No 20152376 PfOJECI Aclivity Type CORRECTIVE IdAINTEN�NCE $12fU i CL <br />StaWs iN3a2C�5 Time 12aa Orig�nal WO . Btllinq _ _ ____ <br />Customer Information <br />Cuslomer Name Customer ld <br />Address Sireet <br />Apartment No C�ry <br />State Z'P <br />Subdivision Change Map Y'N <br />Phone No ( � - Ext <br />Second Phone l �• Ext � <br />E-Mail Address <br />Problem In(ormation <br />Address »�p Street yyALLST <br />From Cross Street <br />To Cross Street <br />City Zip <br />Subdivision Map Book Map Reference <br />Problem WATER WArER <br />Sub Problem OTHER OTHER <br />Requested By Date Requested <br />Agency Related Request <br />Initiated From <br />Uldity Locate (USA) No Called Date Expira6on Date <br />Assig nmenl I�(ormation <br />Depl Prionry Eshmated Hours <br />Crew <br />Contracto� <br />Assigned To � ', �� ', <br />Assigned By ' <br />Assgned Date __ To Be Comp Date <br />Sc.�eduled Date Srheduled Time _ _ <br />Route Roule Sequence <br />Comments <br />Action Taken CONVERT SINCH CURSTOP TO JS iNCH SETTER WITH ME7£R AND BOX. FLAT TO METER <br />PROGRAM. <br />Recommended Action <br />Approved By yVDL W�AVER, DEAN L <br />Start Date � � Time <br />Completed By <br />Jcb Cost InformaPion(Y/N) <br />Date Completed n�xiao�s _ Fermit No ___ <br />Time Foiiow Up� <br />