WORK REQUEST (MAINTENANCE MANAGEMENT)

NAVFAC 9-11014/20 REV.2-68) S/N 0104-LF-002-7510 Supersedes NAVDOCKS 2351 Requester see Instruction on Reverse Side (PW Department see Instructions in NAVFAC MO-321)

PART I - REQUEST (Filled out by Requester)

1. FROM
2. REQUEST NO.

MALS-36 AIRFRAMES W/C 51E

3. TO
4. DATE OF REQUEST

FACILITES MAINTENENCE MCB CAMP BUTLER

5. REQUEST FOR

20110721
5a. REQUEST WORK START

COST ESTIMATE 6. FOR FURTHER INFORMATION CALL

PERFORMANCE OF WORK

POC: SGT LARAMARTINEZ

Phone #:636-3095

8. DESCRIPTION OF WORK AND JUSTIFICATION (Including location, type, size, quantity, etc.)

LOCATION: BLDG. 505 MALS-36 AIRFRAMES W/C 51E TYPE OF WORK: ELECTRICAL DESCRIPTION: OVEN HAS NO POWER CORD AND NEEDS TO GET HARD WIRED. JUSTIFICATION: OVEN NEEDED FOR THE REPLACEMENT OF BEARING CUPS ON AIRCRAFT WHEEL HUBS.

9. FUNDS CHARGEABLE

10. SIGNATURE (Requesting Official)

(SIGNED) DANIEL LARAMARTINEZ

PART II - COST ESTIMATE (filled out by Maintenance Control Division if estimate requested)
11. TO 12. ESTIMATE NO.

13. COST ESTIMATE a. Labor b. Material: c. Overhead and /or Surcharge d. Equipment Rental/Usage e. Contingency f. TOTAL $ $ $ $ $ $

14. SKETCH/PLAN ATTACHED

ZyES

zNO
PROGRAMMING TO START IN______________________________________ BASED ON PRESENT WORK LOAD, THIS JOB CAN BE PROGRAMMED TO START IN__________________________________ IF, AUTHORIZED BY 25th. OF ____________________________ AND FUNDS ARE MADE AVAILABLE

ZAPPROVED. ZAPPROVED.

z DISAPPROVED. (See Reverse Side)

16. SIGNATURE 17. DATE

PART III-ACTION (FILLED OUT BY REQUESTER)

18. TO: 19. AUTHORIZATION TO PROCEED IS ATTACHED (Check one if other than PW funds are involved)

20. WORK REQUESTED

zNAVCOMPT 140
21. SIGNATURE

zOTHER
22. DATE (See Part iv on Reverse Side)

z
HAS BEEN CANCELED

z
HAS BEEN DEFERRED

z
WILL BE PERFORMED BY OTHERS