AF Form 332.pdf

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BASE CIVIL ENGINEER WORK REQUEST

(See Reverse for Instructions) OMB No. 0704-0188

Form Approved

Public reporting burden for this collection of information is estimated to average .3 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to the Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project 0704-0188, Washington DC 20503. Please DO NOT RETURN your form to either of these addresses.

Send your completed form to HQ AFESC/DEMG.

SECTION I - TO BE COMPLETED BY REQUESTER

1. FROM (Organization)

SYMBOL

2. OFFICE 3. DATE OF REQUEST 4. WORK REQUEST NO. (For BCE Use)

5. NAME AND PHONE NO. OF REQUESTER 6. REQUIRED COMPLETION DATE 7. BUILDING, FACILITY OR STREET ADDRESS

WHERE WORK IS TO BE ACCOMPLISHED

8. DESCRIPTION OF WORK TO BE ACCOMPLISHED (Include Sketch or Plan, when appropriate)

9. BRIEF JUSTIFICATION FOR WORK TO BE ACCOMPLISHED (Not required for maintenance and repair)

10. DONATED RESOURCES

FUNDS LABOR MATERIAL CONTRACT BY REQUESTER NONE

11. NAME OF REQUESTER 12. GRADE OF REQUESTER 13. SIGNATURE OF REQUESTER (See Reverse of Form)

14. COORDINATION

SECTION II - FOR BASE CIVIL ENGINEER USE

15. WORK ORDER (Place an "X" in the appropriate box.)

IN-SERVICE SELF-HELP CONTRACT SABER

16. DIRECT SCHEDULED WORK (Place an "X" in the appropriate box.)

EMERGENCY URGENT ROUTINE SELF-HELP M/C

17. SELF-HELP (Place an "X" in the appropriate box.)

BRIEFING REQUIRED ADEQUATE COORDINATION INSPECTION REQUIRED

SECTION III - COMPLETE ONLY IF WORK IS TO BE ACCOMPLISHED BY WORK ORDER

18. WORK CLASS 19. PRIORITY 20. ESTIMATED HOURS 21. ESTIMATED FUNDED

COST

22. ESTIMATED TOTAL

COST

ASSESSMENT (AFR 19-2)

23.

THERE IS NO NEED FOR AN ENVIRONMENTAL

BEING/HAS BEEN PROCESSED

24.

A WRITTEN ASSESSMENT IS APPROVED

25. 26.

DISAPPROVED

27. REMARKS

SECTION IV - APPROVING AUTHORITY

28. NAME AND GRADE (Please Type or Print) 29. SIGNATURE 30. DATE

AF IMT 332, 19910101, V4 PREVIOUS EDITION IS OBSOLETE. MASTER FILE COPY