| Name: | John Pronk | Phone: | 530-363-2745 |
| Email: | johnpronk@icloud.com | Address: | 1720, Granite Hill Road, Placerville, 95667 |
| APN: | 08921068100 | Nearest Cross Street: | Highway 49 |
| Owner of Property: | Yes | Number of Piles: | 1 |
| Pile Size in Feet: | Total width :8, Total length :50, Total height :5 | Material location: | Shoulder of Road |
| Alternative disposition of material: | Take it to El Dorado Disposal | How material was cut and stacked: | I cut and stacked the material myself |
| Number of hours required to do the job: | 5 | Hired someone, how much did it cost: | |
| Applicant agreed to waiver: | yes |
Service Instance | | | |
| Contractor Name: | Admin | Date Serviced (mm/dd/yyyy): | 06/20/2019 |
| Travel Time (in minutes): | 21 | Chipping Time (in minutes): | 43 |
| Actual Pile Size (in feet) | | Total Pile Width: | 6 |
| Total Pile Length: | 98 | Total Pile Height: | 7 |
| Supervisor: | Juan | Crew ID : | |
