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Work Activity Work Order <br />ISsll2d By SJT2 SPOONER, JAMES T. <br />Issued Departmenl Pw PUBLIC WORKS <br />Dale Issued 7'7612009 <br />Fund ao� Account s Program 7to Function »y <br />Program <br />Ti�IC REPAIR MAIN 4020 31TH AVE N E 710119673 <br />Work C'rder No 20090876 Project Activiry Type SERVICE REOUEST <br />Slatus 7/16/2009 Time is:ni Original W0 Billing <br />Customer Information <br />Customer Name SIEBERT, DAVID CUSIOroef Id <br />Address Slreel <br />Apartment No City <br />State Zip sezos <br />S�bdivision Chanae Map Y'N <br />Phone No l azs 1 314-780J Ext <br />Second Phone l 1- Fxt <br />E-Mail Address <br />Problem Information <br />Address 4020 Street 34TH AVE NE <br />From Cross Streel SR 529 <br />To Cross Street <br />ary rp eezos <br />Subdivision Map Book Map Reference <br />Prohlern WATER WATER <br />Sub Problem LEAK LEAK <br />� <br />r„'3. ' <br />7,:,_ � _:�� <br />Activity 6�; <br />S121U5 CL <br />Requested By GMJ2 cesu+K,;.tn��rv,i Date Requested 711612009 <br />Agency Relaled Request 000eoa7� <br />Iniliated From PUBLIC PUouC <br />Utility Locate (USA) No Calied Dale Expiration Date <br />Assignment Infonnation <br />Dept Pw r�u[�uc vdoaKs Priority Estimated Hours <br />Crew <br />Contra ;tor <br />ASSI(Jf1Cd TO SJT2 SPOONGR, JAMES T. <br />Assigned By <br />Assigned Dale 711GI2009 To Be Comp Date <br />Scheduled Dale Scheduled Time <br />Roule Route Sequence <br />CommeMs <br />ACtlOtl TekCll p" pVC 90 WAS BROKE AT [ND OF RIR TRESSEL ON THE NORTH SIDE. REPLACED PVC WITH <br />PrLY AND BACKFILLED HOLE WITH GRAVEL. <br />Recommended Action <br />Approved Dy KTJ KELSQ THOP.fAS J. <br />Start Dale i i Time <br />Completed By <br />Job Cost Information(YIN) <br />Date Compieted meizoos Permit No <br />Time Follow Up? <br />`i3 <br />