SUNY Oswego - Facilities Operations: Service Request Form

(Example only)

Oswego State Facilities & Engineering Service Request

Date Sent: _____________________________	Date Received: __________________________
Requestor Name: ______________________	Requestor Phone#: ______________________

Work Requested:

Building: __________________________________________________________________________	Room # or Equip # or Asset #: _________________________

Problem Description:	Best Guess at Trade (Circle One)
	Building Trades
__________________________________________________________________________	Custodial
	Electrical
__________________________________________________________________________	Furniture
	Grounds
__________________________________________________________________________	Heating / Cooling / Ventilation
	Paint
__________________________________________________________________________	Plumbing

__________________________________________________________________________

Bldg. Coordinator, Hall Director, or Dept Chair Approval Signature: _________________________________________________

q If you desire this work posponed until you are present, check the line provided. For custodial requests in Residence student rooms, schedule your appointment with the desk attendant when completing this request. Other appointments call: Facilities Operations Center - x3200.

For Office use only: Completed _^q

Worker #	Date:	Hours:
Worker #	Date:	Hours:
Worker #	Date:	Hours:

Stock Room Code

Materials:

Stock #

Quantity:

If all UNDERLINED fields are not completed, Service Request will be returned.

White - Maintenance File Canary - Maintenance File Pink - Customer