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op 11 WORK ACKNOWLEDGEMENT FORM3w rKS <br /> JRW <br /> RECEIVED ON 12/02/2021 VIA EMAIL <br /> E-MAINTENANCE TICKET NO, DATE <br /> FACILITY NO.&ADDRESS 7& <br /> CONTRACTOR COMPANY NAME Gettler-Rya llKc. <br /> 6805 Sierra oursSuite <br /> SERVICE REQUESTED ON E-TICKET: Dublin, CA 94568 <br /> t <br /> WORK PERFORMED ONSITE(for parts replaced, provide part name(s), part number(s) &quantities,as applicable): <br /> 4K JA�re <br /> � l <br /> A <br /> A <br /> WAS THE REQUESTED WORK COMPLETED?(circle one YE NO <br /> IF NOT,ESTIMATED RETURN DATE? AND PROVID6ETAIL BELOW ON WHY <br /> lo <br /> -a-�gtots Ae"� r;ko'�r <br /> ARRIVAL TIME �= r.� DID YOU CHECK INTO THE BP IVR?(circle one) YES NO <br /> DEPARTURE TIME : 1p DID YOU CHECK OUT OF THE BP IVR?(circle one) YES NO <br /> NO.OF PERSONNEL ONSITE <br /> A/ 14v"zl -ee <br /> rel S� f--11'L-C� <br /> TECHNICIAN N&ME(P INT LEGIBLY) S RSONNEL(PRI T LEGIBLY) <br /> TEC <br /> IAN NAME(SIGN) SITE ERSONNEL(SIGN) <br /> 2TRIBUTION WHITE-CONTRACTOR COPY / YELLOW SITE COPY <br />