Park West CC(2)-CS 971216 (2)PHONE:(H~. '
COMPLETED:
STREET AI.J~Y
PROBLEM:~/~-~~
STREETS
EMPLOYEE
SIDEWALK .SQ.FL PRIORITY 1 2 3
MATERIAL REOUIRED:
CONCP~TE
ASPRALT
TYPE OFPROBLEM:
HOLDING WATER
POTHOLE
BROKEN
WHO CAUSED PROBLEM:
CUSTOMER
CON'IIe, ACTOR/DEVELOPER
/0T~ITY COMPANY
CAUSE OF PROBLEM:
SETI1JNG
POOR CONSTRUCTION
SHOULDER ROLLING OFF
TURNING RADIUS
OTtIER
_CUSTOMER INFORMED
WEATHER CONDITION: __DRY
SIGNATURE ~ ~
._DOOR KNOCKER
_W T
__HOT __COLD