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� 1 <br /> Service Request oe�o�,=000 ll:oe <br /> Request Intormatlon <br /> RequestNo 000iz�ea Date oaia�iz000 T�m� o�:ae <br /> Recorded By xsn HOFFMIIN, STEVEti R. S�3IUS �P <br /> Department <br /> inidated From ��xc ever.ic <br /> Billing Code <br /> Customer Intormatlon <br /> First Name <br /> vi Last Name sxxraaoN <br /> AddCCSS 1617 RUCRER AVE <br /> Building Apartment No <br /> Ciry Z�p 9ezoi <br /> Phone ( azs ) zs9-caao Ext Alternate Phone ( ) Ext <br /> Problem Informatlon <br /> Add[CSg 1617 ALCKER AVE <br /> Cross Street <br /> City <br /> Problem Details SINK HOLE ZN ALLEY <br /> Probkm seweR saweR <br /> Sub Problem SS <br /> Down Date Down Time <br /> Assignment Intormatlon <br /> SGCVICtd By ]1GA AHLES, GREGORY A. <br /> Dispatched By <br /> RespondedDate oeio�iz000 RespondedTime <br /> Work Onder No . <br /> Activity Intormation <br /> Complered By S�v��'T <br /> Completed Date �- ->3 — �+ U <br /> Action Taken / SQ��2 <br /> �a, R.s-o� s,oce.. <br /> User Defned <br />