Town Center L1B2-LR 990622Utility do Environmental Services, Inc.
P. O. Box 542015 • 1%5 California Crossing FIELD
Dallas, Texas 75354 REPORT
(972) 556 -2913
Fax (972) 556 -1614 ^ Date
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Customer Name : J-- r
Customer Phone
Mobile Phone
Work Requested -�y : J
Job Location : r
Foreman
Address
taken by :
Inspector :
rAwof wak Rquesbd
Valor TV Inspection Leak Detection
Air test Mandrel Sealing
Hydro Test /Chlorine Smoke Testing Line Location
MH Vacuum Test Other
Type ; Size : Length:
Is this pipe New? Yes No Is the pipe Live? Yes No
Wayk Repwr
Time Started : r �� Tme Stopped : Total Hours
TV Tape was give } to • Inspector _ Cust a Other
� x
Remarks: rt i 1 I c j t 1 i le ! C`'
Utility & Environmental Services, Inc.
P. O. Box 542015 • 1%5 California Crossing
Dallas, Texas 75354
Inspector
(972) 556-2913
F ax ( 972 556 -1614 Date
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Customer Name: Address
Customer Phone
Mobile Phone
Work Requesk4ty
Job Location
Foreman :.
Vactor
Air test
Hydro Test /Chlorine
MH Vacuum Test
taken by :
V/_
T � ' �
Type
Is this pipe New? �es No
7)VC of Wak Requtstod
TV Inspection
Mandrel
Smoke Testing
FIELD
REPORT
Leak Detection
Sealing
Line Location
Other
F ; M " I 0.
Size:
Is the pipe Live? Yes C o
wok Repot
Time Started -
TV Tape was gn±em.to :� --�-- Ins�ct4
Tune ��,�/ , �
tzr Other
r,114
Length
1 J
Total Hours