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2. This form has been provided to help you in reporting concerns. If you feel your situation requires immediate attention, please feel free to contact Public Works at 209-895-8060. Our customer service specialist will be happy to assist you!
   
   Please complete all information.
4. Service Being Requested:

   1. Drinking Water Concerns
   2. Collections (sewer overflows, drains, inlets, or manholes)
   3. Sidewalk / Curb and Gutter
   4. Street Lights
   5. Street Repairs (potholes, alleys, other miscellaneous)

   1. Traffic Signals / Signs
   2. Urban Forestry (Street Trees)
   3. Water Waste Complaint
   4. Other
   5. Parks (Maintenance, Irrigation, Streetscapes)
6. If you marked "Other", please specify:
8. Customer First Name:
9. Customer Last Name:
11. Customer Address:
13. Address Continued:
15. City:
16. State:
17. Zip:
19. Home Phone:
20. Cell Phone:
22. Work Phone:
23. Email:
25. Address where service is being requested: (if different than address above):*
27. Request:*
29. Please be aware that if an incomplete order is received, there may be a delay in response time.
    
    Work orders are processed in the order that they are received. Exceptions are made for emergencies or safety hazards only. A supervisor will be making contact with you in the next couple of days. Please allow 2 to 3 weeks for the actual work to be completed. If work has not been addressed within this time, feel free to contact our office for an update.
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31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

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