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Page i <br /> Work Activity Work Order 9/13/2011 �5:z5 <br /> ISSUBCI By WMW WARD,MICHAEL W. <br /> Issued Department Pw PUBLIC WORKS <br /> Date Issued era�zo�t Function ��s Activity 673 <br /> Fund aot Accounts Program ��o <br /> Program <br /> Title INSTALL 761NCH VALVE 70122 7TH AVE SE 710119673 <br /> Work Order No 20111489 PfOJOCf Activity Type CORRECTIVE MAINTENANCE S181U5 CL <br /> Status 8142011 Time iz:ss Original WO Billing <br /> Customer Information Customer ld <br /> Customer Name <br /> Address Street <br /> Apartment No City <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No ( ) • Ext __ _ ____ <br /> Second Phone ( ) - Ext <br /> E-Mail Address — <br /> Problem Information <br /> Address 10122 Street 7TH AVE SE <br /> From Cross Street <br /> '1'o Cross Street <br /> City Zip <br /> Subdivision Map Book Map Refere�ce <br /> Problem <br /> Sub Problem Date Requested <br /> Requested By Related Request <br /> Agency <br /> Initiated From <br /> Utility Locate (USA) No Called Date Expiration Date <br /> Assignment information <br /> Dept Priority Estimated Hours <br /> Crew <br /> Conlractor <br /> Assigned To <br /> Assigned ey To Be Comp Date <br /> Assigned Date _ ___ -- <br /> Scheduled Date _ Scheduled Time _____ <br /> Route Route Sequence <br /> Comments <br /> Action Yaken AVT SERVICE TECH.CONTRACTOR INSTALLED.161NCH INSERTION LINE VALVE. <br /> Recommended Action <br /> Approved By wo� W�VER,DEAN L. JOb COSt IflfOftT18ii0f1(YIN) <br /> Start Date i � Time ___ _ Date Completed a�2si2qtt _ Permit No <br /> Cumpleted By ___ _ _____ Time ___ Follow Up? _ <br />