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Service Request <br />D Infnrmn inn <br />Problem Details 1 Ai *r ! o $' n �G � ° l �� � 5� ,4. <br />Problem Code SGRFTI <br />Down Date Down Time <br />Assignment Information <br />Assigned To Randal Dale <br />Responded Date Time n �D <br />Left Date Left Time e4e <br />Work Order No. <br />Comments <br />Completed By: <br />(name . .... &employee #) <br />Date: ` '? / -0 d <br />P:\ TrafficOperations \TrafficMaintenance \Graffiti \Graffiti Hold Harmless \SR_graffiti_v3.doc <br />Request No <br />Date <br />Time J <br />Status OP <br />Recorded By <br />Billing Code <br />Customer Information <br />Customer Name <br />Address. <br />City <br />"° - <br />Apartment No <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 />City <br />Problem Details 1 Ai *r ! o $' n �G � ° l �� � 5� ,4. <br />Problem Code SGRFTI <br />Down Date Down Time <br />Assignment Information <br />Assigned To Randal Dale <br />Responded Date Time n �D <br />Left Date Left Time e4e <br />Work Order No. <br />Comments <br />Completed By: <br />(name . .... &employee #) <br />Date: ` '? / -0 d <br />P:\ TrafficOperations \TrafficMaintenance \Graffiti \Graffiti Hold Harmless \SR_graffiti_v3.doc <br />