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Issued By Nso <br />Issued Department aw <br />Date Issued 4N912UI3 <br />Fund an� <br />�� ���������,� <br />oage 1 <br />Work Ac�ivity <br />Work Order ?,���Zo13_12_0} <br />NIELSEN, SC07T O. <br />PUBLIC WORKS <br />Account s Program »o <br />Function its <br />ACtIViiY 675 <br />program g CORRECTIVE MAINTENANCE St8fU5 <br />KILL.751NCH 10828 20TH ST SE 710118675 q�tivity Typ <br />Titl2 pro ect <br />NJork Order No 20130814 1 Billing____ _----- --- — <br />411 912 01 3 Time i52a__ ���9inal WO __------ <br />Status __ ____--- -- <br />Customer Information <br />Customer Name <br />Address <br />qpartmentNo <br />State <br />Suudivision � <br />Phone No <br />Second Phone � � - <br />E-Mail Address <br />problem Information <br />Address <br />From Cross Stre?t <br />To C_�oss� t <br />City <br />Subdivision <br />Problem <br />Sub Problem <br />Requested By <br />Agency <br />Iniiiated from <br />Utiliry Locate (USA) No <br />Assignment Information <br />Dept <br />Crew <br />Contracror <br />Assigned To <br />Assigned By <br />Assigned Date __--- <br />ScheduledDate .____--- <br />Route <br />Street <br />City <br />Zip <br />Ext <br />Ext <br />Str_eet <br />Customer ld <br />Map Book <br />Called Date <br />To Be Comp Date <br />Scheduled Time <br />Route Sequence <br />Zio <br />Change Map Y!N <br />Map Reference <br />Date Requested <br />Related Request <br />Expiration Date <br />Priority Estimated Hours <br />Comments <br />A.ction 7aken TERNE E KILLED AT MAIN. LEAVE 2" �u�TROL VALVE STA556 + 14 ON NORTH SIDE OF <br />Recommended Action <br />/�,ppfOV2d By NSO _ NIELSEN. SCOTT 0. <br />� � Time _ ___ <br />Start Date __ . _ - - - <br />Completed Y _ — <br />_ _ <br />- _ <br />CL <br />Job Cost Information(YIN) Permit No <br />Date Completed a�zoi2o�s __— <br />Time _ _ Follow Up? _ __ — <br />