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WORK ORDER <br /> iu. <br /> Work Order No : 0000018 workrrade Inspection <br /> IWA=u <br /> s : Closed Work Type : preventive <br /> Work Priority: Normal <br /> Received by: Christopher Torre Assigned to: Jorge Macias <br /> Received Date/Time: 11/22/2013 <br /> Required Date/Time <br /> Requester: <br /> Phone Number: <br /> PM Target Start Date : 11/26/2013 PM Target End Date: D <br /> Problem Description : Tank linspections <br /> AUG 14 2014 <br /> Notes To Technician Notes to Technician ENVIRONMENTAL H ALTH <br /> (Asset) <br /> (location) ' DEPARTMENT <br /> Failure Code <br /> Checklist No : 194 <br /> Asset No: 9050 Location No: 8600 <br /> Asset Name: Tank Inspections Location Name: SAFETY EQUIPMENT& <br /> INSPECTIONS <br /> Cause Description Action Taken Prevention Taken <br /> checked each on an they look ok an filled out the <br /> Annual internal floating roof top inspection sheet. <br /> • <br /> Parts and Labour Details <br /> F"D <br /> Part Description Issue Type(D/1) UoM Qty Used Qty Returned <br /> =Direct Issue,I=Inventory <br /> 7Employee I Employee No Start Date/Time End Date/Time Normal OT 1 OT 2 OT 3 <br /> Date and Time work was started Date: Time: <br /> Date and Time work was completed: Date: Time-.- <br /> Certification <br /> ime:Certification of Work Completion <br /> Name and Signature of Technician/Engineer Name and Signature of Requestor/Supervisor <br /> . ............... Name ......................... Signature ......................... Name <br /> ......................... <br /> Date: Signature <br /> Time: Date: <br /> Time: <br /> Please rate our services:- 1. Poor 2. Fair 3.Good 4.Very Good 5.Excellent <br /> co"Aght pft symeme Be <br />