| Name: | Graciela Spencer | Phone: | 916-865-8218 |
| Email: | gracespencer61@gmail.com | Address: | 1472, Nesting Way, Placerville, 95667 |
| APN: | 05164020100 | Nearest Cross Street: | Country Club |
| Owner of Property: | Yes | Number of Piles: | 5 |
| Pile Size in Feet: | Total width :6, Total length :6, 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: | 72 | 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): | 36 | Chipping Time (in minutes): | 12 |
| Actual Pile Size (in feet) | | Total Pile Width: | 4 |
| Total Pile Length: | 3 | Total Pile Height: | 4 |
| Supervisor: | Juan | Crew ID : | |
