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� 5 A 9.. ';b�� <br />Work Acfiivity Work f�rder <br />,,�_ ; <br />S/22i2u�5"! 13:5° <br />ISSU2d By CAG CRUM, GERRY � <br />Issued Departmenl Pw PUBLIC WORKS <br />Dale Issued 3izenoo� <br />�����d qp� Account s Program »o Funclion >>9 Activity 673 <br />Program <br />TIIIC TAP II INCH 9406 18TH AVE W 710119664 <br />Work Order No 20�70264 Project Activity Type CORRECTIVE MAINTENANCE <br />Date 3r..sizom Tirne o�:�s Original WO 2oo�ozss Billing <br />Customer Information <br />Customer Name <br />Address <br />Apariment No <br />Slate <br />Subdivision <br />Phone No ( 1 . <br />Second Phone ( 1 <br />E-Mail Address <br />Problem Invormation <br />Address 9406 <br />From Cross Street <br />To Cross Street <br />City <br />Subdivision <br />Problem <br />Sub Problem <br />Requesl�� 3y <br />Agency <br />Inilialed From <br />Utilily Locate (USA) No <br />Assignment Information <br />Dept <br />Crew <br />Contractor <br />Assigned To <br />Assigned By <br />Assigned Date <br />Scheduled Date <br />Route <br />Comments BILL JOB (#1) <br />Action Taken <br />Slreet <br />City <br />Zip <br />Ext <br />Ext <br />Slreet 18i''i�`VFW <br />Map Book <br />Called Date <br />To Be Comp Dale <br />Scheduled Time <br />Route Seyuence <br />Cus!omer ld <br />Chanae �1ap Y/N <br />Zip <br />Map Re(erence <br />Cste P.equested <br />Related Request <br />Expiralion Date <br />Priority <br />Eslimated Hours <br />SlaWs c� <br />