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_ sx <br /> File Edit Tools Help �yr Tuesday,April 29,2014 <br /> 4111111W+ 1 0 G Y <br /> Back Forward Home Refresh Print Reports Quick Launch <br /> Enter Service Request Details <br /> N <br /> Enter details for the service request in the fields below.Click Save and Continue when you are finished. <br /> 1 of 1 I P� Service Request Type Service Request <br /> J� <br /> Contact Information Crick here to Vhow deta'& <br /> Service Request Information <br /> Facility ID: Billing Account ID: <br /> Record ID: SROD69530 ❑Update address <br /> Facility Name: RALPHS SQUARE <br /> Site location: 2122 5 AIRPORT WAY,STOCKTON <br /> Copy Address With: <br /> Add a Service Request Comment <br /> Entered date: 412912014 Entered by: JYOAKUh Update dater Update by: <br /> Location and Owner Information <br /> Property owner WHITE,RALPH LEE <br /> Number: 2122 Direction: 5 Street name: AIRPORT Street type: WAY <br /> Unit type: Unit: APN: 16916201 <br /> City: STOCKTON State: CA ZIP Code: 95026 <br /> Country: USA Location: STOCKTON - District code: �VILLAPUDUA <br /> Phone 1: (209)464-8526 Phone 2: (209)467-1006 <br /> Requestor Information <br /> Requestor: DANIEL VILLANUEVA-AGE for <br /> eSave - [�Options [_ Copy Service Request G*Save and Continue <br /> Workflow:Add a Service Request Connected User:]YOAKUM ! Database:EC-PROD Server:EH-ENVC i <br /> 4t Start UJ Inbox-JYoakum@sjceh.,. I Check a License-Licens... I L�EnvisionConnect « ® 10:31 AM <br /> Tuesday,Apr 29,2014 10:31 AM <br />