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Service Request <br /> Req�est Information <br /> Request i�o 000ms� Da'.e 2iznoos Time �s:�� St�tus PR <br /> Recorded By MBR MOSS,BRIAN R. <br /> Billing Code <br /> Customer Information <br /> Customer Name BARBERG, MR Customer id <br /> Address 3901 HIGF:Si <br /> Apar!m�nt No City t-iP I <br /> Phone No ( ) Exl Second Phone ( ) Ex.t <br /> E�Mail Address <br /> Problem Information ! <br /> Address 1309 �lreet 39TH ST � <br /> From Cross Street To Cross Street <br /> Initiated From PUBLIC PUBLIC <br /> City Subdivision <br /> Problem Details ON 39TH ST BETWEEN 391'H Si AND RUCKER OR HIGH STREET'�i 1309 39TH STREET <br /> Froblem WATERI WATER <br /> Sub Problem �`',�ly_ <br /> Down �ate Down Time <br /> Assignment Information <br /> Assigned To CSG CAVANAH, SH.4NE G. <br /> Respondec! Date �-,Z��f Responded Time <br /> Left Date Left Time <br /> Work Order No. <br /> A,ction Taken <br /> Compieted By: �����(�o- Date: �j � q � � <br /> Loyged By � <br /> � � ����� <br /> ��-�n� /� �� ` , <br /> � <br /> �� % z�� � S ;�c��� �3 <br />