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11Vork Activity Work Order <br />IssuedBy SJTz sroorven,JHIVICJ•• <br />Issued DepartmentPw PUBLIC WORKS <br />Date Issued sianoia <br />Fund ao� Account5 Program <br />Program UT3473 3 3 <br />TIfl2 CONVERT .751NCH 2601 21 ST ST UT347333 <br />Work Order No 2013256'I Project <br />Status __ __9�anoi3 Time ia_so Original WO __ <br />Customer Information <br />Customer Name <br />Address <br />Apartment No <br />State <br />Subdivision <br />Phone No � > � <br />Second Phone ( 1 - <br />E-Mail Address <br />Problem Information <br />Address 2601 <br />From Cross Street <br />To Cross Street <br />City <br />Subdivision <br />Street <br />City <br />Zip <br />Ext <br />Ext <br />Street 21ST ST <br />Problem WATER WATER <br />Sub Problem OTHER OTHER <br />Requested By <br />Agency <br />Initiated From <br />Utility Locate (USA) No <br />Assignment Information <br />Dep: <br />Crew <br />Contractor <br />Assigned To <br />Assigned By <br />Assigned Date ____._ <br />Scheduled Date . _ <br />Route <br />Comments <br />Functian <br />PdGo ' <br />10/7.4/2013 i�:C6 <br />Activity <br />Hcfivity Type CORRECTIVE MAINTENANCE <br />--- — — - Billin9----------- <br />Map Book <br />Called Date <br />To Be Comp Date <br />Scheduled Time <br />Route Sequence <br />Customer ld <br />Zip <br />Priority <br />Change Map YIN <br />Map Reference <br />Date Requested <br />Related Request <br />Expiration Date <br />Estimated Hours <br />$�BtUS CL <br />� ., -;» .� . . _ ... <br />���t"ai. �a.°�%,' �'`. <br />Action Taken CONVERT .75 INCH CURBSTOP TO .75 INCH SETTER WITH METER AND BOX. FLAT TO METER <br />PROJECT. <br />Recommended Action <br />Job Cost Information(YIN) <br />Approved By HLJ HUSBY, LANCE J PEfflllt NO <br />Start Date � � Time _ Date Completed �omzola _ <br />Completed By <br />— -- -- Time Follow Up? <br />