Energy Request Form

PLEASE NOTE: Starting July 1, 2013 all requests will go through a web based system called Maintenance Direct. Training sessions (about 1 hour) will be held each Monday at 11 am in the Facilities Management conference room starting on May 20, 2013 through Labor Day. Call 487-3288 to reserve a seat.

Use this form for non-emergency scheduled energy management requests. If this is an emergency, call Public Safety at 906-487-2216.

The contents of this form will be submitted to the Control Room in the Heating Plant. Please print a copy for your records.

Note: All fields are required in order to properly fulfill your work request

Customer Environment Area

Requested By

Telephone #

Contact Name

Dept, Office, or Div

E-Mail Address

Work Area Description:

BuildingPlease select from the following listACADEMIC OFFICESADMINALUMNIANNEXAPSRCATDCCENTRAL RECEIVINGCHEM-SCICHPDANIELL HEIGHTSDHHDILLMANDOWEERCFISHERFORD FORESTRY CENTERFORESTRYGATESGOLF COURSEGREAT LAKES RESEARCH CENTERHAMAR HOUSE -CDIHILLSIDE PLACEKRCLAKESHORE CENTERLAKESIDE LABLIBRARYLITTLE HUSKIES CHILD CAREMM&EMCNAIR EASTMCNAIR WESTMCNAIR KITCHENMEEMMEESE CENTERMINERAL MUSEUMMUBOTHER/NOT LISTEDPORTAGE MEDICALPRES RES. #45REKHI HALLRIPLEY SKI HILLROTCROZSARUPPE HOUSE #82SDCSERVICE AND STORAGEWADS HALLWADS KITCHENWALKERWIDMAIER

Room #

General Area of Problem

 Heating   Ventilation   Cooling   Other  

Job Description

Desired Completion Date