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�� <br /> l/lfork Activity Work Order <br /> ISSUed By SJT2 SPOONER,JAMES T. <br /> Issued Department Pw PUBLIC WORKS <br /> Dalelssued cnonoos <br /> Fund aot Acr,o�.mt 5 Pro�ram 7tu Function ��g Aclivily s�s <br /> Program <br /> T1�10 �[�':.Ili 3972 79TH ST 710119675 <br /> VVorkOrderNo 20090715 Projecl ActiviryType ! ��!c!_ ��:r�u����s� St:�tus c� <br /> Slatus e�t0 zoo�! Time �z.7 Onp�nal �:JO 6illing <br /> Customer Information <br /> Customer Name ci+n�rnnN, �knoev Customer ld � <br /> Address 707G SlfCBt RUCKERAV[ I <br /> Apartment IJo Ciry <br /> State Zip so2o� <br /> Subdivision Change Iv1ap 'rilV � <br /> Phone fJo ( azs 1 z3aa2aa Ext <br /> Second Phone ( � - Ext <br /> E-Mail Address <br /> Problem Information <br /> Address 3g�2 Street 39TH ST <br /> From Cross Street HIGH ST <br /> To Cross Street RUCKER AVE <br /> CIIY ZI� 90201 <br /> Subdivision Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Pr�blem LEAK LEAK <br /> Requesled By HSR HOFFMAN,STEVEN R. D2le R�qU8Sl2d 611 012 0 0 9 <br /> Ngency Related Request 000�ses� <br /> Initiated From Puauc r�u[�uC <br /> Utility Locale (USA) No Called Date Fxpiration Dale <br /> Assignment Information <br /> Depl Pw �ut�uc N�ortKs Priority Eslimaled Hours <br /> Crew <br /> Conlraclor <br /> ASSI(��8d TO SJT2 SPOONER,JAMES T. <br /> Assigned By <br /> Assigned Dale ���onoos To Be Comp Date <br /> Scheduled Date Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Taken �g80'S POLYIREPLACED WINEW POLY JUMPER <br /> Recommeoded Action <br /> Approved 8y �GM2 �7�UKERS,GEORGE M. JOb COSt IflfOffTl2li0f1(Y/N) <br /> Start Date I i Time Date Completed 6110f2009 Permit No <br /> Completed By Time Folle�v Up? <br /> �, - �-*i <br /> ..�5^.aP=ti�.-,.....,..—�.._--_._ _ . ...,... ..o�..r.e, . -- _"_.... . - l .�_ ,__ Ji6�!� �t �z!1:L <br />