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1C <br />Service Request <br />Request Information ( } <br />k ! Y^ <br />Problem Details Y'\ <br />� �IC - 3 4 f w <br />Problem Code SGRFTI <br />Down Date 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: _ Date: — <br />(name ..... &employee }1) <br />A. <br />P:\ TrafficOperations \TrafficMaintenance\ Graffiti \Graffiti Hold Hartntess\SR graffiti_v3.doc <br />Request No <br />Date `� <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 />k ! Y^ <br />Problem Details Y'\ <br />� �IC - 3 4 f w <br />Problem Code SGRFTI <br />Down Date 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: _ Date: — <br />(name ..... &employee }1) <br />A. <br />P:\ TrafficOperations \TrafficMaintenance\ Graffiti \Graffiti Hold Hartntess\SR graffiti_v3.doc <br />