Preview Customer Contact Report

City of Hollister

Customer Contact Report

Associate Engineer (Utilities) Utilities Supervisor Senior Maintenance Worker

Date: _________________ Time: _____________

Name of Contact: __________________________________

Address: ______________________________ Mailing Address: _______________________

Phone Number: _________________________ Account Number:_______________________

___ Sewer Inspection ___ Sewer Spill (See back of Contact Report)

___ Sewer Connection ___ Report of Sale/Transfer ___ Emergency H2O Turn Off

___ Backflow Required? ___ Change of Address ___ End H2O Meter Read

___ Odor Complaint ___ H2O Service: On/Off ___ High Water Use

Reason for Call:

____________________________________________________________________________

Office Comments:

____________________________________________________________________________

Supervisors Comments:

____________________________________________________________________________

Problem Corrected? _________ Inspected By:__________________________ Date:______

Follow Up Activities: ____________________________________________________________

____________________________________________________________________________

Correspondence sent out? ________ Dated:___________

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