Work Request Plant Maintenance
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1WORK REQUEST
PLANT MAINTENANCE
REQUESTED BY: ____________________PHONE: ________________ DEPT ___________________________DIVISION______________________
DEPT.
DIV
VP
AUTHORIZED BY: HEAD(S) _________________________
DIR(S)_________________________
(S) _____________________________
CAMPUS _____________________ BUILDING _________________ ROOM ____________ PRIORIT REQUESTED
URGENT
ROUTINE
TYPE OF WORK
NEW CONSTRUCTION
REMODELING
RENNOVATION
MAINTENANCE
FUNDING SOURCE (ACCOUNT NUMBER)
NOTE:
ANY WORK REQUESTED OTHER THAN MAINTENANCE MUST HAVE A FUNDING SOURCE IDENTIFIED
DATE SUBMITTED :_______________________ DATE REQUIRED ______________________ DPT. CODE NO. _____________________
DESCRIPTION OF WORK, MATERIAL REQUESTED OR JUSTIFICATION
ATTACHMENTS:
PLANS ____________________
SKETCH _____________________
DESCRIPTION _______________
CAMPUS SERVICES
FOR PLANT MAINTENANCE ONLY
PLANT MAINTENANCE
s
C
_______________________
__________________________
RE Repairs
SA Safety
CAMPUS
BUILDING
ROOM
TYPE OF WORK
NE New Construction
CO Capital Outlay
PR VIP Requested
OC Outside Contractor
AUTHORIZING SIGNATURE (S)
ASSIGNMENT:
CARPENTRY-CA PAINTING-PA- PLUMBING-PL METAL-ME A/C-AC
GROUNDS-GA
KEYS-KE
ELECTRIC-EL
MOTOR
POOL-MO-
DELIVERY-DE
CONSTRUCTION CRE-CC MODULAR FURNITURE-WE ROOFER-RF
LEAD SHOP ___ ___ ___ ___ ___
PROJECT COMPLETION
________________________________ _____/_____/_______
SHOP FOREMAN’SIGNATURE
DATE
COST SECTION:
MAN HOUR
M/H ____________________________
PROJECT SCHEDULES DATE
ESTIMATED
MATERIAL
_____________________________
TODAY’S DATE
_____ _____/_____ _____/_____ ____
PRIORITY
(1 2 3)
(4 5 6)
(7 8 9)
ON HOLD
_____ _____/_____ _____/_____ _____
ESTIMATED MATERIAL DELIVERY DATE
EMERG.
URG.
ROUT.
_____ _____/_____ _____/_____ _____
PROPOSED START DATE
_____ _____/_____ _____/_____ ______
ESTIMATED COMPLETION DATE: ATE
:
INSTRUCTIONS
1.
Requestor must complete through the description section and attach any plans and specs as required.
2.
Campus Services must process and send to Plant Maintenance Dept.
3.
Plan Maintenance Dept will return the green and pink copies with detailed estimated of the work
4.
If the request is returned with a price of other than maintenance, the requestor must send a copy of the
budget amendment to the Plant Maintenance Department to activate the work order.
DISTRIBUTION:
MAINTENANCE OFFICE, CAMPUS SERVICES, ORIGINATOR
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Parent category: Business