Service Request <br />Request Information <br />Date Time Status OP <br />Request No - ` <br />Recorded By <br />Billing Code <br />Customer Information <br />Customer Name <br />Apartment No <br />Address <br />Zip <br />City Ext <br />Phone No ( ) <br />Ext Second Phone ( ) <br />E -Mail Address <br />Problem Information <br />Address Street <br />Cross Street <br />City <br />Problem Details <br />Problem Code SGRFTI <br />Down Time <br />Down Date <br />Assignment Information <br />Assigned To Randal Dale <br />Time <br />Responded Date <br />Left Date <br />Left Time <br />Work Order No. <br />Comments <br />Date: <br />Completed By: <br />(name ..... &employee #) <br />P:\ TrafficOperations \TrafflcMaintenance \Graffiti \Graffiti Hold Harmless \SR graffiti_v3.doc <br />