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Eugene Concrete Pipe Co. (541) 689-5523 Date j ; , <br /> Corvallis Concrete Pipe Co. (541) 752-3475 <br /> I Eugene Fax # (541) 689-5530 <br /> ~ Project r3 <br /> NDUSIRIES IVY TECHNICAL SERVICES ~ _ <br /> Work Authorization and Report <br /> Engineer <br /> Customer: _ : , v~- <br /> I <br /> I <br /> JOB DATA <br /> Type of line Size of Pipe New Old <br /> ~ From M, H, TO M. H. Going Towards <br /> Personnel on Job + < ~ <br /> 'i JOB DESCRIPTION <br /> Air Test Vac Test TV BrGraut - Grouting Isolation Cleaning <br /> Other <br /> REPORT OF WORK PERFORMED <br /> ~ Footage Description or Air Loss in Pounds Time Grout <br /> f { ~ <br /> r:. <br /> r ~ :i± f <br /> i <br /> i <br /> On Job <br /> i <br /> Time Started <br /> Time Completed Signed <br /> TfaVel Tlme Technical Service Representative <br /> <br /> ~ i <br /> ~ <br /> <br />