Work Order Request Form

WORK ORDER REQUEST FORM
JH FIRE/EMS– MAINTENANCE DEPARTMENT
Attention: Maintenance Officer Meagher
Requester Name: _________________________ Date: _____________________
Station: _______________________________ Telephone:
Location: _________________________________ Vehicle of Concern: ______________
Out of Service Criteria: Yes No Duty Officer:
Duty Officer Notified: Yes No
Mileage at Time of Request:__________________
Description of Work Order Requested:
-----------------------
Maintenance Use Only
---------------------------
Description of completed Work Order and Material Used:
Completed By: _____________________________ Date: _____________________________
Time Started: _____________________________ Time Ended: _______________________
The JH Fire/EMS Maintenance Department receives and process work request orders daily. Our overall goals
are to schedule and complete these services in a timely manner. In order to perfect our goals, each Requesting
Party must complete a work order form and return it to the Maintenance Officer; either in person, by fax (739-
9856) or by email: dmeagher@tetonwyo.org. Thank you in advance for your cooperation.
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