Master_Utility_Outage.pdf
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- F3QCCL6062A003
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Master Utility Outage
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Text version
UTILITY OUTAGE REQUEST
DATE:
CHECK OUTAGE TYPE: Electrical Water Steam Chilled Water Other
IF OTHER, EXPLAIN:
FACILITY NUMBER(S):
FACILITY MANAGER SIGNATURE AND ANY REQUIRED USER COORDINATION
LABOR RELATIONS COORD REQUIRED: YES NO
(DATE) AT REQUEST OUTAGE BEGINNING:
SIGNATURE:
ENDING ON: (DATE) AT (TIME)
REASON FOR
OUTAGE:
REQUESTER:
PROJECT NUMBER:
COMPANY:
PHONE NUMBER:
PROJECT/CONTRACT MONITOR NAME:
PHONE NUMBER:
SHOP COORDINATION Facilities Super Infrastructure Super Utilities Super INITIAL AS NEEDED Alarms Industrial Mechanical Utilities
Interior HVAC Fire Dept Exterior Zone 1 Other Power Production
78 CES/CEPC (SERVICE CALL MUST COORDINATE ON ALL OUTAGES AND RECEIVE A COPY OF
SIGNED OUTAGE REQUEST)
OUTAGE IS APPROVED/DISAPPROVED:
This form effective 03/17/2006
(TIME) AND
78 CES/CL
After electronically completing top portion of form, print for coordination initials and approval signature.
UTILITY OUTAGE REQUEST
DATE:
CHECK OUTAGE TYPE:
IF OTHER, EXPLAIN:
FACILITY NUMBER(S):
FACILITY MANAGER SIGNATURE AND ANY REQUIRED USER COORDINATION
LABOR RELATIONS COORD REQUIRED:
YES
NO
(DATE) AT
REQUEST OUTAGE BEGINNING:
SIGNATURE:
ENDING ON:
(DATE) AT
(TIME)
REASON FOR
OUTAGE:
REQUESTER:
PROJECT NUMBER:
COMPANY:
PHONE NUMBER:
PROJECT/CONTRACT MONITOR NAME:
PHONE NUMBER:
SHOP COORDINATION
Facilities Super Infrastructure Super Utilities Super
INITIAL AS NEEDED
Alarms Industrial Mechanical Utilities Interior
HVAC
Fire Dept Exterior Zone 1 Other Power Production
78 CES/CEPC
(SERVICE CALL MUST COORDINATE ON ALL OUTAGES AND RECEIVE A COPY OF
SIGNED OUTAGE REQUEST)
OUTAGE IS APPROVED/DISAPPROVED:
This form effective 03/17/2006
(TIME) AND
78 CES/CL
After electronically completing top portion of form, print for coordination initials and approval signature.
UTILITY OUTAGE REQUEST
Preferred Customer Normal.dot william.fowler Microsoft Office Word
3/10/2006 1:32:00 PM
3/10/2006 1:30:00 PM
3/10/2006 1:32:00 PM
Dell Computer Corporation 28672
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