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Service Request <br />Request Information <br />/ 141'71 <br />Request No <br />Date <br />t D -l�s <br />Time (Z ; rO Status OP <br />Recorded By <br />L� ��' At GLlrl°�t', <br />°, a1ael <br />Billing Code <br />Customer Name <br />Apartment No <br />Address <br />City <br />Zip <br />Phone No ( ) <br />Ext <br />Second Phone ( ) Ext <br />E -Mail Address <br />Problem Information <br />Address <br />Street <br />Cross Street <br />r <br />Problem Details {�'� <br />/ 141'71 <br />L� ��' At GLlrl°�t', <br />°, a1ael <br />Problem Code SGRFTI <br />Down Date <br />Down Time <br />Assignment Information <br />Assicaned To Randal Dale <br />Responded Date Time <br />Left Date <br />Left Time <br />Work Order No. <br />Comments <br />..,- >`� � �"�""; Date: <br />Completed By . / <br />ame ..... &employee #) <br />P:\ TrafficOperations \TraffieMaintenance \Graffiti \Graffiti Hold Harmless \SR_graffiti_v1doc <br />