Work Request Instructions

    30 August 2010

    Work Request Instructions

    Requests for equipment installations, building modifications, self-help material, any work related to a safe (including combination changes), keys and cipher lock installations need to be submitted on a work request form.

    The preferred method of submittal is by email.

    It saves time and is a great way to track submitted work requests.

    If you require an electronic version of the form or to submit a work request, please submit an email to LEMR_PUBLICWORKS-WORKREQUESTS@navy.mil

    (Address is in Address Book, under All Groups) to:

    The easiest way is to fill out the form and save it to your hard drive. Attach it to an email and send it to the email address above.

    Please put the work request number in the subject line of the email.

    If emailing the form, it must be sent from a person that has a Signature Card Authorization form on file with Public Works.

    If you do not have email capability, the work request can be faxed to x4132/x4163 or hand delivered to Public Works Production Control, Building 750.

    If submitting the form by fax or hand delivering, it must be signed by a person who has a Signature Card Authorization form on file with Public Works.

    Phone Numbers:

    x3846
    x4138
    x4121
    Trouble Desk x4123

    Please note the following exceptions:

    1. All work requests to cut new keys, for additional keys, or the rekeying of locks, must be routed thru the base Physical Security Specialist at (559) 998-4756.  If you do not have email capability the work request can be faxed to x4741 or hand delivered to the Security, Bldg. 782.

    Note: The designated Key Custodian MUST submit these types of work requests, otherwise it will be denied.

    ******** KEY CUSTODIAN LETTERS MUST BE ON FILE AT SECURITY ********

    2. All work requests related to intrusion alarm systems or installation of cipher locks, must be routed through the base Physical Security Specialist, phone number (559) 998-4756.  If you do not have email capability the work request can be faxed to x4741 or hand delivered the Security, Bldg. 782.

    WORK REQUEST ITEM DEFINITIONS

    THE FOLLOWING BLOCKS MUST BE FILLED OUT: 1, 2, 3, 4, 5a, 6, 8, and 10

    (5, 7, 9 ARE OPTIONAL)

    BLOCK #’S:

    1. Your Activity/Squadron.

    2. Work Request Number composed of:
    XXX
    – Your 2 to 4 digit Public Works Department assigned customer code. For squadrons, your code is your squadron number excluding VFA. For all others, if you are unsure of your customer code, please call x3846/x4138/x4121.

    3. Type in “Public Works Department Lemoore”.

    4. Date work request prepared.

    5. Check one box. If you intend to fund the work, select the “Cost Estimate” box.

    5a. Date work requested to start.

    6. POC: Name and PHONE NUMBER of individual most aware of work required, not necessarily the Signature Card Authorization holder. This would be the person we would contact for further information.

    7. Check appropriate box and attach sketch whenever it will provide clarification.

    8. The following 3 items are REQUIRED:
    Location:
    The exact location where the requested work will be performed.
    Request:
    Describe what you want as clearly as possible and state when you what the work to be performed. If you are requesting a generator, please state which parts of your facility you need to have powered and for how long.
    Justification:
    State your reason for requesting the work.

    9. IF reimbursable customer, please provide Job Order Number(s) if known.

    10. If emailing, type in the name of the Signature Card Authorization form holder that is emailing it in. If faxed or hand delivered, the Signature Card Authorization holder must PRINT AND SIGN the form. (To find out whom your signature card holder is please call x3846/x4138/x4121)

    WORK REQUEST (MAINTENANCE MANAGEMENT) (PW Department see

    NAVFAC 9-11014/20 REV. 2-68) S/N 0105-LF-002-7510 Instructions in NAVFAC MO-321)

    Supersedes NAVDOCKS 2351

Y – This is the last digit of the fiscal year that the work was requested in. (Example: For fiscal year 10, it would 0). This changes at the beginning of each new fiscal year, which is 1 October.
001
– 999: This is a sequential number established by your activity and maintained in a log by a designated individual. This number will reset to 001 at the beginning of each FY, which is 1 October.

  •  

      Examples: CSFWP = CSF0001, VFA-151 = 1510001

PART I - REQUEST (Filled out by Requestor)

1. FROM

Activity, Department, or Squadron

2. REQUEST NO.

XXXYXXX

3. TO

Public Works Department Lemoore

4. DATE OF REQUEST

DAY MONTH YEAR

5. REQUEST FOR

☐ COST ESTIMATE ☐ PERFORMANCE OF WORK

5a. REQUEST WORK START

REQUIRED

6. FOR FURTHER INFORMATION CALL

Contact info (NAME AND PHONE NUMBER) for individual that is best to contact about work.

7. SKETCH/PLAN ATTACHED

☐ YES ☐ NO

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

LOCATION: Where do you want the work to be performed? BLDG #/ ROOM #/ HANGER/ MOD/ ROOM / ETC.
For Example:
BLDG 240 HGR 5 MOD 3 RM 113 PR SHOP; BLDG 737, CSP Director’s office; BLDG 160, RM 022

REQUEST: What are you requesting? When do you need it?
For Example:
Generator installed to support maintenance control shops; Replace carpet in room; Install additional outlets

JUSTIFICATION: Why are you requesting the service?
For Example:
Mission Essential services impacted if not provided; Current carpet is torn and is a safety hazard; Outlets required to support new equipment

SAMPLE WORK REQUEST SAMPLE WORK REQUEST SAMPLE WORK REQUEST

LEAVE “PART II – COST ESTIMATE” BLOCKS BELOW BLANK

9. FUNDS CHARGEABLE

If reimbursable customer add Job Order Number here if known.

10. SIGNATURE (Requesting Official)

If emailing, typed name of Signature Card Authorization holder. If faxing or hand delivering, Signature Card Authorization holder must PRINT AND SIGN.

PART II - COST ESTIMATE

(Filled out by Maintenance Control Division if estimate requested)

11. TO:

12. ESTIMATE NO.

13. COST ESTIMATE

14. SKETCH/PLAN ATTACHED

   

☐ YES ☐ NO

a. Labor

15.

b. Material

☐ APPROVED: PROGRAMMING TO START IN .

c. Overhead

and/or Surcharge

 

☐ APPROVED: BASED ON PRESENT WORKLOAD, THIS JOB CAN BE

d. Equipment

Rental/Usage

PROGRAMMED TO START IN , IF

e. Contingency

AUTHORIZED BY 25TH OF AND FUNDS

ARE MADE AVAILABLE.

☐ DISAPPROVED. (See Reverse Side)

f. TOTAL

16. SIGNATURE

17. DATE

PART III - ACTION (Filled out by Requestor)

18. TO:

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

 

☐ NAVCOMPT 140 ☐ OTHER

20. WORK REQUESTED

HAS BEEN HAS BEEN WILL BE PERFORMED

☐ CANCELLED ☐ DEFERRED ☐ BY OTHERS

21. SIGNATURE

22. DATE

(See Part IV on Reverse Side)

 

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