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FACILITIES MAINTENANCE REQUEST FORM
BUILDING
LOCATION (Rm #, area, etc.)
NAME
REQUEST DATE
DESCRIPTION OF PROBLEM OR REQUEST
_
Return to BUILDING ADMINISTRATOR
Administrator Approval Signature
Date
Building Secretary will enter request in computer when approved.
Maintenance Department will receive request and work action will be taken.
NOTE: Except for kitchen repairs, custodial supply requests and emergencies, action will not be taken without the building
administrator’s approval. Emergencies should be called into the building administrator and the business office.
Emergencies are sudden unforeseen situations, which require immediate action. Example – power outage, broken pipe,
communication system failure, heating system failure. Comfort problems are not an emergency.
FACILITIES MAINTENANCE REQUEST FORM
BULIDING
LOCATION (Rm #, area, etc.)
NAME
REQUEST DATE
DESCRIPTION OF PROBLEM OR REQUEST
_
Return to BUILDING ADMINISTRATOR
Administrator Approval Signature
Date
Buildi