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Unit:

Manager:

Phone:

E-mail Address :

Requested date of completion:

Today's date:

Project type: Repair    Maintenance   New Construction

Description:

Special Instructions:

Charge to my Cost Objects Account #:

Funds available for project:

Funds expire on:

Design needed for this project

An estimate is needed for this project

Other:

Comments:

Please provide drawings, sketches, or other information to Dwight Hanson, ARDC Facilities Operations Manager.

NOTE: Only Unit Managers shall initiate work requests by completing this form (or at least the first box) for all FORESEEN projects. For unforeseen emergency repairs only, the Unit Manager or designee shall notify the appropriate crewmember and/or the Facilities Manager, then document the request. None in Facilities Operations will be held responsible for unwritten work requests.