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V4'orlc Activity Work Order Pagr � <br /> 11/22/2Gp5 10:20 <br /> Issued By wMp WELLMAN,MARK F. <br /> Issued Department Pw PUBLIC WORI(S <br /> Date Issued �visnoos <br /> Fund ao� Account s Program ��o Function >>y Ac(ivily 573 <br /> Program <br /> Tifl2 II!NCH TAP 470 13TH ST 710119673 <br /> WOfk O�dBf NO 2��5 i�E� PfOj@Ct Activiry Type CORRECTIVE MAINTC-NA{JCC- Sf0lU5 pR <br /> Date tvisizooS Timeia is Original WO Billing <br /> Customer Information <br /> Customer Name TRITQN CONSTRUCTION Customer ld <br /> Address Street <br /> Apariment No Cib� <br /> State Zip <br /> Subdivision Change Map Y/N <br /> Phone No l ) - Ext <br /> Second Phone ( ) - Ext <br /> E-Mail Address <br /> Problem Infonnation <br /> Address Street <br /> From Cross Street <br /> To Cross Street <br /> City ZiP <br /> Subdivision Map Book Map Reference <br /> Problem <br /> Sub Problem <br /> Requested By <br /> Agency Date Requested <br /> initiaied From Related Reo�est <br /> Utility Locate (USA) No Called Date Expiration Date <br /> Assignment Information <br /> Dept <br /> Crew Priority Estirnated Hours <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assigned Date To �e Cump Date <br /> Scheduled Date Scheduled Time <br /> Roule Roule Sequence <br /> Comments <br /> Action Taken ����-L— / � � <br /> _ _ <br /> _ -�2/TDrJ i%YZ�j,�/� ����5'✓ <br /> 1��5` /3�, —, <br /> - - _ _ _ �"� <br /> _ - _ <br /> � _ _ _ <br /> ��/��c',�'-- ��'�/_- _ <br /> . <br /> ��7t/ � ��-.�i S <br /> . �4..�-,� <br />