Work Request Form - Operations

Work Request Form - Operations
Name*

First NameLast Name
Date*

MonthDayYear
Date
Time*

:HourMinutes
Surface Location*
Downhole Location (if applicable)*
** If Downhole is not applicable please enter 6 in all fields**
Which company should the work be charged to?*

Teine Energy (Light Oil)Teine Heavy Oil Partnership
If on a small engine what is the TEL #?
What priority is this job?*

1 - Immediately2 - By End of Today3 - Next Day4 - By End of Work Week (FRIDAY)5 - Next Week6 - Other (complete at turnaround, next service etc..)
When would you like work to be completed?*
Work Type*

CompressorElectrical and InstrumentationEngineGeneral MaintenancePump JackOther
Description of work needed to be done*
Take Photo / Upload File

Cancelof
Foreman Area*

Avon Hill North - Scott OsterholdAvon Hill South - Wayne DeschnerChauvin Core North - Jeff SeffernChauvin Core South - Dustin McMannChauvin Edgerton - Kurtis TranmerChauvin Midstream - Chuck KrahnColeville - Chris SolomonDodsland PWT - Cory TurkDodsland South - Scott OsterholdDuvernay - Leonard OchreyHoosier - Trent MartinMaintenancePlato - Wayne DeschnerAll Areas
Charge to what area?*

Avon Hill North - Scott OsterholdAvon Hill South - Wayne DeschnerChauvin Core North - Jeff SeffernChauvin Core South - Dustin McMannChauvin Edgerton - Kurtis TranmerChauvin Midstream - Chuck KrahnColeville - Chris SolomonDodsland PWT - Cory TurkDodsland South - Scott OsterholdDuvernay - Leonard OchreyHoosier - Trent MartinPlato - Wayne DeschnerAll Areas
Work Request will be automatically sent to Foreman and Lead based on selection made above.
Area Run #
Type of Production Affected*

OilGas
Production amount affected*
Operator phone number*
Comments
Should be Empty:

Work Request Form - Operations

Work Request will be automatically sent to Foreman and Lead based on selection made above.