| Name: | Dana Bergman | Phone: | 530-748-3745 |
| Email: | Brandonndana@hotmail.com | Address: | 4977, Cedar drive, Camino, 95709 |
| APN: | 07611108100 | Nearest Cross Street: | Fern |
| Owner of Property: | Yes | Number of Piles: | 1 |
| Pile Size in Feet: | Total width :4, Total length :8, Total height :4 | Material location: | Driveway |
| Alternative disposition of material: | Burn it | How material was cut and stacked: | I cut and stacked the material myself |
| Number of hours required to do the job: | 8 | Hired someone, how much did it cost: | |
| Applicant agreed to waiver: | yes |
Service Instance | | | |
| Contractor Name: | Admin | Date Serviced (mm/dd/yyyy): | 06/21/2019 |
| Travel Time (in minutes): | 21 | Chipping Time (in minutes): | 17 |
| Actual Pile Size (in feet) | | Total Pile Width: | 7 |
| Total Pile Length: | 20 | Total Pile Height: | 4 |
| Supervisor: | Jose | Crew ID : | |
