Lab Ventilation Shut-Down Request

The following form should be submitted whenever work being performed will remove, or potentially interrupt service on HVAC equipment that serves critical lab space. The Shutdown Request must be submitted to EHS at least 3 business days prior to the requested shutdown date to allow time for coordination with Lab Occupants. Longer advance notice may be necessary for complex or involved shutdown requests.

Please call in all emergencies and urgent requests: Environment, Health and Safety 608/209-8466 or 608/333-6315.

Please fill out the following information and press the "Submit" button at the bottom.

Requested Work Start Date:*
MM/DD/YYYY
Requested Work Start Time:**
Requested Work Stop Date:*
MM/DD/YYYY
Requested Work Stop Time:**
Requester's Full Name:*
Lead Trades Person's Full Name:*
Department:*
Phone or Pager Number:*
Email:*
Building Code/Building Name:*
Fan PM Number/Fan Name:*
Description of Maintenance Service Requested:
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