EFTA00126230.pdf

FBOP WO Tech Facility Minor Work Request NYM TO: FACILITY MANAGER FROM: NYM Footties • Feathers THRU: _ Facility Manager. HS,/ (Entered by:) (Department) (Phone) (Department Head Signature) Site: NYM Building: 3RD Location: LIEUTENANT OFF - LIEUTENANT OFF Work Location: SIS Corn Tech You aro requested to perform the following work: DVR Failure it 2 DVR Failure # ltDVR falure # 2 if Applicable. ensure all safety precautions are fanned b inctude but not limited to tockouttragout. Confined Space Fatty. a Fail Motecton" Date Active: 7119(2019 Status: ACTH Priority No: 2 Facility Manager. TMS No.: 10481 (AtMang °nature) You are authorized to perform the above work: To Foreman: CM01 - CMOI - Skill: Communication Warden's signature for greater than $1e000 IF WORK ORDER WAS CREATED FROM A PM, ENTER PM WORK ORDER ft List below all materials used: Pescrlotion chiontity Iliad Unit Price Tehl fa° tifteklykie fil .5roar Grand Total: If Applicable, ensure that the equipment bin a MWI label afitad In deer view and legible. PAWI o Asbestos Abatomont is required or has been completed. Foreman's Total Hours: 2'0 ❑ FITARA process is required. Date Contented: Upon completion of work, complete form and return to the Facility Manager. H Signet e Completion Comments: Re94(41 (10744„telodPrW6 EFTA00126230  FBOP WO Tech Facility Minor Work Request 10481 NYM Ch101 TO: FACILITY MANAGER FROM: NYM Facilities • Facilities DMU: Facility Manager //SU (Entered ter) (Department) (Phone) (Department Head Signature) Site: NYM 13tredimip 3RD Location: LIEUTENANT OFF - LIEUTENANT OFF Work Location: SIS Corn Test You are requested to perform the following work OVR II 2 DVR Faule a 1/ DVR tadise # 2 If Applicable, eneuro ell safety precautions ere followed to Include but not limited to '' Lockout/Tag out. Confined Space Entry. & Foll Date Active: 7/19/2019 Status: CM P LT Priority No: 2 Facility Manager: 'MIS No.: 10481 (Authorizing Signature) You are authorized to perform the above work: To Foreman: O401 -CMOs Skill: Communication Warden's signature for greater than 510,000 IF WORK ORDER WAS CREATED FROM A PM, ENTER PM WORK ORDER List below all materials used: poscrlotion Qtlagliti nti Llnit Price Eta Grand Total: If Applicable, ensure that the equipment hase MWI label affixed In clear view ond legible. MWI e: ❑ Asbestos Abatement Is required or has been completed. Foreman's Total Hours: ❑ FITARA process Is required. Date Completed: 8/2612019 Upon completion of work, complete form and return to the Facility Manager. Staff Signature Completion Comments: 1 EFTA00126231