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Content
WORK REQUEST
PLANT
MAINTENANCE
REQUESTED BY:
PHONE
DEPT. REQUEST NO.
DIVISION
DEPT.
DEPT.
AUTHORIZED BY: HEAD(S)
DIV
DIR(S)
CAMPUS
BUILDING
TYPE OF WORK:
V.P.
(S)
ROOM
NEW CONSTRUCTION
REMODELING
(If required)
PRIORITY
REQUESTED URGENT
RENOVATION
ROUTINE
MAINTENANCE
FUNDING SOURCE (ACCOUNT NUMBER).
NOTE: ANY WORK REQUEST OTHER THAN MAINTENANCE MUST HAVE A FUNDING SOURCE IDENTIFIED
DATE SUBMITTED:
DATE REQUIRED:
DEPT. CODE NO.
DESCRIPTION OF WORK, MATERIAL REQUESTED, OR JUSTIFICATION
ATTACHMENTS: PLANS
SKETCH
CAMPUS SERVICES*
DESCRIPTION
FOR PLANT MAINTENANCE ONLY
PLANT MAINTENANCE *
S
CAMPUS
C
BUILDING
ROOM
TYPE OF WORK: RE Repairs
NE New Construction
PR VIP Requested
AUTHORIZING SIGNATURE(S)
/
PROJECT OF COMPLETION
SHOP FOREMAN'S SIGNATURE
COST SECTION:
MAN HOUR M/H
ESTIMATED
MATERIAL
PRIORITY:
(123)
(456)
EMERG.