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Work Activity Work Order ''�e 1 <br /> _ . — - - <br /> �i;izoio e:ie <br /> ISSU2d BY SJT2 SPOONER,JAMES T. <br /> Issued Department Pw PUBLIC WORKS <br /> Date Issued va�2oio <br /> Fund ao� Account s Program 7to Funclion �i9 Activiry s�s <br /> Program <br /> TI118 REPLACE 75 INCH 2117 15TH ST 710119675 <br /> WOfk OfdOf NO 2����0�$ PfOJ2CI ACtivity TypB CORRECTIVE MAINTENANCE SI8tU5 PR <br /> Status va�zoto Time oa:t5 Original WO BilGng <br /> Customer Information <br /> Cuslomer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> Slate 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 p�17 Street i5THST <br /> From Cross Street <br /> To Cross Slreet <br /> City Z�P <br /> Subdivision Map 600k Map Reference <br /> Problem <br /> Sub Problem <br /> Requested By Date Requesled <br /> Agency Related Request <br /> Initiated From <br /> Utility Locate(USA) No Called Dale Expiration Date <br /> Assignment Information <br /> Dept Priority Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assi�ned Date To Be Comp Date • <br /> Scheduled Dale Scheduled Time <br /> Route Route Sequence <br /> Comments / /� J ^ <br /> Action Taken ..� ✓15T� ��C� l�E'rTf� - r,f"_ l G G�t'�_ �J`� <br /> � 75 �'n�� l�//5w�:�pz.� - `� �oX� -- ------ - ----- --- <br /> � <br />