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Work Activity Work Order <br />Pege 1 <br />ia/zo/zoi9 i3:ze <br />186UQd By CfG CAVANAM, BMANE O. <br />Issued DepaRmentvw PUSLICWORK8 <br />Date Issued tantou <br />Fund rot Account s Program no Function �tf Activity ttt <br />Progrem <br />T11k REPAIR BO b07 B�TH ST SE 770119871 <br />N/Orlf OfdBf NO ��u�Oe PfOJlCt ACIIViry TyP@ SERVICE RE�UEST St8tU9 CL <br />Status �oroiYou Time tas2 OrfginalWO Billing <br />Cu�tom�► Inform�tlon <br />CUStOmet Name CMINO, J06EPM <br />Addresn �of <br />ApaAment No <br />State <br />Subdivision <br />Phone No l �is ) �tei2oe <br />Second Phone ( 1 - <br />E-Mail Addrcss <br />ProbNm Informatlon <br />Address DDY <br />�p_Cross Street <br />To Cross Streel <br />Cily <br />Subdivision <br />StfBCt i/TH 8T SE <br />City <br />Zip <br />Ext <br />E� <br />Street 91THSTSE <br />Problem WATER WATER <br />Sub Problem LEAK LEAK <br />Requested By ORA DURRANT, ROGEii A <br />Agency <br />I�itiated From vusuc PUBLIC <br />Utiliry Locate (USA) No <br />A�s{pnm�nt Inform�tion <br />Dept <br />Crew <br />CoMractor <br />Assigned To M�K <br />Aasigned By <br />Assigned Date <br />Scheduled Date <br />Roule <br />Comnwnri <br />Map Book <br />Called Date <br />MCKEEHAN,JACOBK. <br />To Be Comp Date <br />Scheduled i'ime <br />Route Sequence <br />Customer ld <br />Zip <br />Change Map YIN <br />Map Reference <br />Date Requested to�eisuu <br />Related Request oo�Hsft <br />Expiration Date <br />Prioriry Estimated Nours <br />_ ��'1���� If.i u �` � i:: � �� <br />� �' <br />Action T�ken REPLACED lLOW OFF WITM NEW lLOWOPF. MAD TO INSTALL DEAD MEN TO RESTMIN CAP. <br />R�comrn�nd�d Actlon <br />Approved By MYYE MOORE, WARREN E. JOb COSf I�(Ofrt19fi0f1(Y/N) <br />Sfart Date � � Time �ale Completed tvioito�� Permit No <br />Completed By Time _ Follow Uo9 <br />