REQUISITION/WORK FORM
Date
*
-
Month
-
Day
Year
Date
Job #
*
Employee Filling Out Form
*
NIPPLES
SIZE
QTY
*
3/8 x 2 1/2
1/2 x 1 1/2
1/2 x 2
1/2 x 2 1/2
1/2 x 3
1/2 x 3 1/2
1/2 x 4
1/2 x 4 1/2
1/2 x 5
1/2 x 5 1/2
1/2 x 6
3/4 x 1 1/2
3/4 x 2
3/4 x 2 1/2
3/4 x 3
3/4 x 3 1/2
3/4 x 4
3/4 x 4 1/2
3/4 x 5
3/4 x 5 1/2
3/4 x 6
1 x 2
1 x 2 1/2
1 x 3
1 x 3 1/2
1 x 4
1 x 4 1/2
1 x 5
1 x 5 1/2
1 x 6
1 1/4 x 2
1 1/4 x 2 1/2
1 1/4 x 3
1 1/4 x 3 1/2
1 1/4 x 4
1 1/4 x 4 1/2
1 1/4 x 5
1 1/4 x 5 1/2
1 1/4 x 6
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
*
3/8 x 2 1/2
1/2 x 1 1/2
1/2 x 2
1/2 x 2 1/2
1/2 x 3
1/2 x 3 1/2
1/2 x 4
1/2 x 4 1/2
1/2 x 5
1/2 x 5 1/2
1/2 x 6
3/4 x 1 1/2
3/4 x 2
3/4 x 2 1/2
3/4 x 3
3/4 x 3 1/2
3/4 x 4
3/4 x 4 1/2
3/4 x 5
3/4 x 5 1/2
3/4 x 6
1 x 2
1 x 2 1/2
1 x 3
1 x 3 1/2
1 x 4
1 x 4 1/2
1 x 5
1 x 5 1/2
1 x 6
1 1/4 x 2
1 1/4 x 2 1/2
1 1/4 x 3
1 1/4 x 3 1/2
1 1/4 x 4
1 1/4 x 4 1/2
1 1/4 x 5
1 1/4 x 5 1/2
1 1/4 x 6
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
*
3/8 x 2 1/2
1/2 x 1 1/2
1/2 x 2
1/2 x 2 1/2
1/2 x 3
1/2 x 3 1/2
1/2 x 4
1/2 x 4 1/2
1/2 x 5
1/2 x 5 1/2
1/2 x 6
3/4 x 1 1/2
3/4 x 2
3/4 x 2 1/2
3/4 x 3
3/4 x 3 1/2
3/4 x 4
3/4 x 4 1/2
3/4 x 5
3/4 x 5 1/2
3/4 x 6
1 x 2
1 x 2 1/2
1 x 3
1 x 3 1/2
1 x 4
1 x 4 1/2
1 x 5
1 x 5 1/2
1 x 6
1 1/4 x 2
1 1/4 x 2 1/2
1 1/4 x 3
1 1/4 x 3 1/2
1 1/4 x 4
1 1/4 x 4 1/2
1 1/4 x 5
1 1/4 x 5 1/2
1 1/4 x 6
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
*
3/8 x 2 1/2
1/2 x 1 1/2
1/2 x 2
1/2 x 2 1/2
1/2 x 3
1/2 x 3 1/2
1/2 x 4
1/2 x 4 1/2
1/2 x 5
1/2 x 5 1/2
1/2 x 6
3/4 x 1 1/2
3/4 x 2
3/4 x 2 1/2
3/4 x 3
3/4 x 3 1/2
3/4 x 4
3/4 x 4 1/2
3/4 x 5
3/4 x 5 1/2
3/4 x 6
1 x 2
1 x 2 1/2
1 x 3
1 x 3 1/2
1 x 4
1 x 4 1/2
1 x 5
1 x 5 1/2
1 x 6
1 1/4 x 2
1 1/4 x 2 1/2
1 1/4 x 3
1 1/4 x 3 1/2
1 1/4 x 4
1 1/4 x 4 1/2
1 1/4 x 5
1 1/4 x 5 1/2
1 1/4 x 6
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Caps
SIZE
QTY
*
3/8"
1/2"
3/4"
1"
1 1/4"
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
*
3/8"
1/2"
3/4"
1"
1 1/4"
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
*
3/8"
1/2"
3/4"
1"
1 1/4"
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
*
3/8"
1/2"
3/4"
1"
1 1/4"
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Unions
SIZE
QTY
*
3/8"
1/2"
3/4"
1"
1 1/4"
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
*
3/8"
1/2"
3/4"
1"
1 1/4"
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
*
3/8"
1/2"
3/4"
1"
1 1/4"
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
*
3/8"
1/2"
3/4"
1"
1 1/4"
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
90's
SIZE
QTY
*
3/8"
1/2"
3/4"
1"
1 1/4"
1/2" x 3/8" Reducer
3/4" x 1/2" Reducer
1" x 1/2" Reducer
1" x 3/4" Reducer
1 1/4" x 1" Reducer
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
*
3/8"
1/2"
3/4"
1"
1 1/4"
1/2" x 3/8" Reducer
3/4" x 1/2" Reducer
1" x 1/2" Reducer
1" x 3/4" Reducer
1 1/4" x 1" Reducer
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
*
3/8"
1/2"
3/4"
1"
1 1/4"
1/2" x 3/8" Reducer
3/4" x 1/2" Reducer
1" x 1/2" Reducer
1" x 3/4" Reducer
1 1/4" x 1" Reducer
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
*
3/8"
1/2"
3/4"
1"
1 1/4"
1/2" x 3/8" Reducer
3/4" x 1/2" Reducer
1" x 1/2" Reducer
1" x 3/4" Reducer
1 1/4" x 1" Reducer
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Couplings
SIZE
QTY
*
1/2"
3/4"
1"
1 1/4"
1/2 x 3/8" Reducer
1/2" x 3/4" Reducer
1" x 1/2" Reducer
1" x 3/4" Reducer
1 1/4" x 1" Reducer
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
*
1/2"
3/4"
1"
1 1/4"
1/2 x 3/8" Reducer
1/2" x 3/4" Reducer
1" x 1/2" Reducer
1" x 3/4" Reducer
1 1/4" x 1" Reducer
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
*
1/2"
3/4"
1"
1 1/4"
1/2 x 3/8" Reducer
1/2" x 3/4" Reducer
1" x 1/2" Reducer
1" x 3/4" Reducer
1 1/4" x 1" Reducer
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
*
1/2"
3/4"
1"
1 1/4"
1/2 x 3/8" Reducer
1/2" x 3/4" Reducer
1" x 1/2" Reducer
1" x 3/4" Reducer
1 1/4" x 1" Reducer
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Black Iron Pipe
SIZE
QTY
*
Yes
No
*
Yes
No
*
Yes
No
*
Yes
No
Shutoff's
SIZE
QTY
*
Yes
No
*
Yes
No
*
Yes
No
*
Yes
No
636 Pipe/Fittings
SIZE
QTY
*
Yes
No
*
Yes
No
*
Yes
No
*
Yes
No
PVC Pipe/Fittings
SIZE
QTY
*
Yes
No
*
Yes
No
*
Yes
No
*
Yes
No
GAS/AC Copper Rolls
SIZE
QTY
*
Yes
No
*
Yes
No
*
Yes
No
*
Yes
No
Electrical
SIZE
QTY
*
Yes
No
*
Yes
No
*
Yes
No
*
Yes
No
Conversion Kits
SIZE
QTY
*
Yes
No
*
Yes
No
*
Yes
No
*
Yes
No
AC Fittings
SIZE
QTY
*
Yes
No
*
Yes
No
*
Yes
No
*
Yes
No
Flare Fittings
SIZE
QTY
*
Yes
No
*
Yes
No
*
Yes
No
*
Yes
No
BBQ Material
SIZE
QTY
*
Yes
No
*
Yes
No
*
Yes
No
*
Yes
No
DID YOU INSTALL EQUIPMENT TODAY
*
Yes
No
EQUIPMENT YOU INSTALLED TODAY
Choice
Furnace
Air Conditioner
Coil
Hot Water Heater
HRV
Boiler
Heat Pump
Air Handler
Fireplace
Geothermal
Take Photo
WORK COMPLETED TODAY
Submit
Should be Empty: