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Service Request <br />RnnuPCt 1nfnrmnfinn 1 , \ I Q 1; 1 I / ; <br />i <br />Problem Details a <br />4 I�0, Le <br />cct <br />- _ Iii <br />SGRFTI <br />Down Date I Down Time <br />Assignment Information <br />Assigned To Randal Dale <br />Responded Date Time <br />Left Date Left Time <br />Work Order No. <br />Comments <br />Completed By: <br />Date: <br />(name ..... &employee U <br />P:\ TrafficOperations \TrafflcMaintenance\ Graffiti \Graffiti Hold Harmless\SR graffiti_v3.doc <br />Request No <br />Date —7 , 0 3 O <br />>� <br />Time <br />Status OP <br />Recorded By <br />Billing Code <br />Customer Information <br />Customer Name <br />Address <br />Apartment No <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 />City <br />i <br />Problem Details a <br />4 I�0, Le <br />cct <br />- _ Iii <br />SGRFTI <br />Down Date I Down Time <br />Assignment Information <br />Assigned To Randal Dale <br />Responded Date Time <br />Left Date Left Time <br />Work Order No. <br />Comments <br />Completed By: <br />Date: <br />(name ..... &employee U <br />P:\ TrafficOperations \TrafflcMaintenance\ Graffiti \Graffiti Hold Harmless\SR graffiti_v3.doc <br />