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STREET LIGHT MAINTENANCE REQUEST

TOG_PW STREET LIGHT MAINTENANCE REQUEST  
Please give an accurate description of the location of the streetlight. The street name, the closest
intersection and pole number would be very helpful, if they are possible to obtain. The pole number is located at eye level on the street side of the pole.
 
Date Reported  
Reported By  
Address  
Phone Number  
Pole Location Description  
Pole Number  

Problem

 
   
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