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Eugene Concrete Pipe Co. (541) 689-5523 Date ~.t ~ <br /> 1 ~ Corvallis Concrete Pipe Co. (541) 752-3475 <br /> Eugene Fax # (541) 689-5530 <br /> ~ N~DUS~RIES IVY TECHNICAL SERVICES Project r , <br /> -rr <br /> Work Authorization and Report En sneer a <br /> I g <br /> I <br /> ~ Customer: qtr= <br /> j ~ reg. <br /> i <br /> <br /> i <br /> JOB DATA <br /> Type of line Size of Pipe New Old <br /> ;I From M, H. TO M, H. Going Towards <br /> ~ Personnel on Job m r4 ~ 7,r <br /> JOB DESCRIPTION <br /> ` Air Test Vac Test TV & Grout Grouting Isolation Cleaning <br /> Other ~eC~ ~ <br /> i <br /> i <br /> REPORT OF WORK PERFORMED ~ <br /> Footage Description or Air Loss in Pounds Time Grout <br /> l ~ <br /> ti; rt-v A< < t r <br /> _ ~ <br /> 1 <br /> ~ t ~ ~ S Y?l to S.- ;:a,s~ t Lc. - .-i- ,'3 I l~C.+rr-„ j,.....:t S <br /> I ~ <br /> <br /> ~ /\i7c 'n °yi r1r~ v a. r' t*:"~L ~r'~S U;-t ~ <br /> f~ <br /> ~ ~ It r- S r t is [ Jfi '..",~'a' t ! ~`i i .:'.Y` r <br /> ^y,. 1 <br /> II` ~ r~ G.a, p: _'~~h' 'S rf T s:~'°S f !'rf c . Y~~ r~T/~~ <br /> 1 <br /> , r J ~ <br /> •r , <br /> ~ ~ ri <br /> 1 ! <br /> I <br /> 1 <br /> I <br /> ~I <br /> On Job <br /> Time Started ~ <br /> Time Completed Signed <br /> Travel Time Technical Service Representative I~ <br /> 1 <br /> <br />