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0 <br />'J <br />UTILITY WORK ORDER <br />Date: �- 5 �^u d� �yq7ER <br />S�" <br />❑ SEWER <br />O STCRM <br />$'i5 ��a � �� sE <br />Location: <br />CITY OF EVERETT <br />DEPARTMENT OF PUBLIC WORKS <br />UTILITIES DIVIS!ON <br />�I f =�f --� a -s <br />�—�-- - <br />_ — : _; <br />_ � � . <br />� SEFVICE <br />� MAIN <br />C] PUMP STATION <br />❑ TREATMENT <br />❑ RESEFVOIR <br />❑ VALVE <br />❑ MAN HOLE <br />O CATCH BASIN <br />❑ DITCH <br />►i,...� _ ..� <br />W.O. No. _ <br />Acct. No. � <br />Complaint No. <br />l� MAINTENANCE <br />❑ OPERATION <br />❑ REPAIR <br />❑ CONSTRUCTION <br />?093 <br />- �V V�J / <br />ESTIMATED <br />L�bor (hours) <br />Materiel (cost) <br />Equipment fcost) <br />ACTUAL _ <br />Labor(hours) <br />Materiai (cost) <br />�quip cent (cost) <br />SCHEDULING REOUESTED <br />USE CHARGE ACCOUNT NUMBER BELOW FOR LABOR TIME SLIPS. ITEMIZE <br />LABOR, EOUIPMENT, AND MATERIALS ON REVERSE SIDE. <br />Completion (Date): _ ��Zll� y <br />Cost:$ <br />Charge Account Number: <br />. __ �harge Cost To (Name)• <br />Addr�`�;_: <br />Invoice No.: <br />Amo �t$_ <br />0 <br />