REQUISITION/WORK FORM
Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Job #
*
Employee Filling Out Form
*
NIPPLES
Rows
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
Rows
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
Rows
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
Rows
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
Rows
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
Rows
SIZE
QTY
*
Yes
No
*
Yes
No
*
Yes
No
*
Yes
No
Shutoff's
Rows
SIZE
QTY
*
Yes
No
*
Yes
No
*
Yes
No
*
Yes
No
636 Pipe/Fittings
Rows
SIZE
QTY
*
Yes
No
*
Yes
No
*
Yes
No
*
Yes
No
PVC Pipe/Fittings
Rows
SIZE
QTY
*
Yes
No
*
Yes
No
*
Yes
No
*
Yes
No
GAS/AC Copper Rolls
Rows
SIZE
QTY
*
Yes
No
*
Yes
No
*
Yes
No
*
Yes
No
Electrical
Rows
SIZE
QTY
*
Yes
No
*
Yes
No
*
Yes
No
*
Yes
No
Conversion Kits
Rows
SIZE
QTY
*
Yes
No
*
Yes
No
*
Yes
No
*
Yes
No
AC Fittings
Rows
SIZE
QTY
*
Yes
No
*
Yes
No
*
Yes
No
*
Yes
No
Flare Fittings
Rows
SIZE
QTY
*
Yes
No
*
Yes
No
*
Yes
No
*
Yes
No
BBQ Material
Rows
SIZE
QTY
*
Yes
No
*
Yes
No
*
Yes
No
*
Yes
No
DID YOU INSTALL EQUIPMENT TODAY
*
Yes
No
EQUIPMENT YOU INSTALLED TODAY
Rows
Choice
Furnace
1
Air Conditioner
2
Coil
3
Hot Water Heater
4
HRV
5
Boiler
6
Heat Pump
7
Air Handler
8
Fireplace
9
Geothermal
10
Take Photo
WORK COMPLETED TODAY
Submit
Should be Empty: