Stockbridge-Munsee Community
Property & Equipment Department
Work Order Form
Print Name: ________________________ Department: ___________________________ Date: _____-_______-_________
Work Requested
Heating/Air Conditioning Electrical Plumbing
Structural/ Building Grounds Work Furniture
Housekeeping Painting Other
Brief Explanation of Problem: __________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
________________________________________ ___________________
Department Manager’s Signature Date
________________________________________ ___________________
Facilities Maintenance Manager Signature Date
When you have completed the work order form, send to Charles Gardner via Interoffice mail, email or by faxing to (715)793-4878.
------------------------------------------------------------ P&E Office Use Only----------------------------------------------------
Date Assigned: ______-_______-________ Assigned to: _____________________________________
Date Completed: ______-_______-_________ Completed by: ___________________________________
Notes: _______________________________________________________________________________________________
_____________________________________________________________________________________________________
____
_________________________________________________________________________________________________
Submit
click to sign
signature
click to edit
click to sign
signature
click to edit