<div>&nbsp;</div>

<div align="center"><br />
<font size="5"><strong>设备故障维护工作申请单</strong></font><br />
&nbsp;</div>

<div align="center">
<table border="1" bordercolor="#ffffff" class="xdLayout" style="border: currentColor; width: 698px; border-collapse: collapse; table-layout: fixed; -ms-word-wrap: break-word;" tabindex="65535">
	<colgroup>
		<col style="width: 90px;" />
		<col style="width: 90px;" />
		<col style="width: 90px;" />
		<col style="width: 80px;" />
		<col style="width: 80px;" />
		<col style="width: 80px;" />
		<col style="width: 80px;" />
		<col style="width: 108px;" />
	</colgroup>
	<tbody valign="top">
		<tr style="min-height: 35px;">
			<td colspan="2" style="border-width: 1.5pt 1pt 1pt 1.5pt; border-style: solid; border-color: rgb(0, 0, 0) black black rgb(0, 0, 0); padding: 1px; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;">故障设备工作项目</font></div>
			</td>
			<td colspan="6" style="border-width: 1.5pt 1.5pt 1pt 1pt; border-style: solid; border-color: rgb(0, 0, 0) rgb(0, 0, 0) black black; padding: 1px; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;"><input align="left" hidden="0" name="DATA_1" size="67" style="width: 510px; height: 19px; text-align: left;" title="工作项目" /></font></div>
			</td>
		</tr>
		<tr style="min-height: 35px;">
			<td style="border-width: 1pt 1pt 1pt 1.5pt; border-style: solid; border-color: black black black rgb(0, 0, 0); padding: 1px; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;">故障日期</font></div>
			</td>
			<td colspan="2" style="padding: 1px; border: 1pt solid black; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;"><input align="left" hidden="0" name="DATA_2" size="18" style="width: 141px; height: 19px; text-align: left;" title="故障日期" /><img _fcksavedurl="/module/html_editor/editor/images/calendar.gif" align="absMiddle" alt="" border="0" class="DATE" date_format="yyyy-MM-dd" name="DATA_23" src="/static/images/form/calendar.png" title="日期控件:故障日期" value="故障日期" /></font></div>
			</td>
			<td colspan="2" style="padding: 1px; border: 1pt solid black; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;">期望维护或完工日期</font></div>
			</td>
			<td colspan="3" style="border-width: 1pt 1.5pt 1pt 1pt; border-style: solid; border-color: black rgb(0, 0, 0) black black; padding: 1px; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;"><input align="left" hidden="0" name="DATA_3" size="29" style="width: 228px; height: 19px; text-align: left;" title="期望完工日期" /><img _fcksavedurl="/module/html_editor/editor/images/calendar.gif" align="absMiddle" alt="" border="0" class="DATE" date_format="yyyy-MM-dd" name="DATA_24" src="/static/images/form/calendar.png" title="日期控件:期望完工日期" value="期望完工日期" /></font></div>
			</td>
		</tr>
		<tr style="min-height: 150px;">
			<td style="border-width: 1pt 1pt 1pt 1.5pt; border-style: solid; border-color: black black black rgb(0, 0, 0); padding: 1px; vertical-align: middle;">
			<div align="center" style="line-height: 2;"><font face="宋体" style="font-size: 11pt;">故障状况或</font></div>

			<div align="center" style="line-height: 2;"><font face="宋体" style="font-size: 11pt;">工作说明</font></div>
			</td>
			<td colspan="7" style="border-width: 1pt 1.5pt 1pt 1pt; border-style: solid; border-color: black rgb(0, 0, 0) black black; padding: 1px; vertical-align: top;">
			<div style="line-height: 1.5;"><font face="宋体" style="font-size: 11pt;"><textarea cols="66" name="DATA_4" rich="0" rows="7" style="width: 603px; height: 143px;" title="故障状况"></textarea></font></div>
			</td>
		</tr>
		<tr style="min-height: 81px;">
			<td rowspan="2" style="border-width: 1pt 1pt 1pt 1.5pt; border-style: solid; border-color: black black black rgb(0, 0, 0); padding: 1px; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;">工务单位</font></div>
			</td>
			<td colspan="3" style="padding: 1px; border: 1pt solid black; vertical-align: top;">
			<div style="line-height: 1.5;"><font face="宋体" style="font-size: 11pt;"><textarea cols="28" name="DATA_5" rich="0" rows="4" style="width: 257px; height: 76px;" title="工务单位意见"></textarea></font></div>
			</td>
			<td rowspan="2" style="padding: 1px; border: 1pt solid black; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;">申请单位</font></div>
			</td>
			<td colspan="3" style="border-width: 1pt 1.5pt 1pt 1pt; border-style: solid; border-color: black rgb(0, 0, 0) black black; padding: 1px; vertical-align: top;">
			<div style="line-height: 1.5;"><font face="宋体" style="font-size: 11pt;"><textarea cols="28" name="DATA_7" rich="0" rows="4" style="width: 263px; height: 76px;" title="申请单位意见"></textarea></font></div>
			</td>
		</tr>
		<tr style="min-height: 35px;">
			<td colspan="3" style="padding: 1px; border: 1pt solid black; vertical-align: middle;">
			<div align="right"><font face="宋体" style="font-size: 11pt;">主管签字：<input class="AUTO" datafld="SYS_USERNAME" hidden="0" name="DATA_6" style="width: 120px;" title="工务单位主管签字" value="{MACRO}" /></font></div>
			</td>
			<td colspan="3" style="border-width: 1pt 1.5pt 1pt 1pt; border-style: solid; border-color: black rgb(0, 0, 0) black black; padding: 1px; vertical-align: middle;">
			<div align="right"><font face="宋体" style="font-size: 11pt;">主管签字：<input class="AUTO" datafld="SYS_USERNAME" hidden="0" name="DATA_8" style="width: 120px;" title="申请单位主管签字" value="{MACRO}" /></font></div>
			</td>
		</tr>
		<tr style="min-height: 35px;">
			<td style="border-width: 1pt 1pt 1pt 1.5pt; border-style: solid; border-color: black black black rgb(0, 0, 0); padding: 1px; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;">成本记录</font></div>
			</td>
			<td style="padding: 1px; border: 1pt solid black; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;">开始日期</font></div>
			</td>
			<td style="padding: 1px; border: 1pt solid black; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;">完工日期</font></div>
			</td>
			<td style="padding: 1px; border: 1pt solid black; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;">总工时</font></div>
			</td>
			<td style="padding: 1px; border: 1pt solid black; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;">折算工资</font></div>
			</td>
			<td style="padding: 1px; border: 1pt solid black; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;">材料费用</font></div>
			</td>
			<td style="padding: 1px; border: 1pt solid black; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;">分摊费用</font></div>
			</td>
			<td style="border-width: 1pt 1.5pt 1pt 1pt; border-style: solid; border-color: black rgb(0, 0, 0) black black; padding: 1px; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;">总成本</font></div>
			</td>
		</tr>
		<tr style="min-height: 35px;">
			<td style="border-width: 1pt 1pt 1pt 1.5pt; border-style: solid; border-color: black black black rgb(0, 0, 0); padding: 1px; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;">估计</font></div>
			</td>
			<td style="padding: 1px; border: 1pt solid black; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;"><input align="left" hidden="0" name="DATA_9" style="width: 60px; text-align: left;" title="估计开始日期" /><img _fcksavedurl="/module/html_editor/editor/images/calendar.gif" align="absMiddle" alt="" border="0" class="DATE" date_format="yyyy-MM-dd" name="DATA_25" src="/static/images/form/calendar.png" title="日期控件:估计开始日期" value="估计开始日期" /></font></div>
			</td>
			<td style="padding: 1px; border: 1pt solid black; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;"><input align="left" hidden="0" name="DATA_10" style="width: 60px; text-align: left;" title="估计完工日期" /><img _fcksavedurl="/module/html_editor/editor/images/calendar.gif" align="absMiddle" alt="" border="0" class="DATE" date_format="yyyy-MM-dd" name="DATA_26" src="/static/images/form/calendar.png" title="日期控件:估计完工日期" value="估计完工日期" /></font></div>
			</td>
			<td style="padding: 1px; border: 1pt solid black; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;"><input align="left" hidden="0" name="DATA_11" style="width: 75px; text-align: left;" title="估计总工时" /></font></div>
			</td>
			<td style="padding: 1px; border: 1pt solid black; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;"><input align="left" hidden="0" name="DATA_12" style="width: 75px; text-align: left;" title="估计折算工资" /></font></div>
			</td>
			<td style="padding: 1px; border: 1pt solid black; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;"><input align="left" hidden="0" name="DATA_13" style="width: 75px; text-align: left;" title="估计材料费用" /></font></div>
			</td>
			<td style="padding: 1px; border: 1pt solid black; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;"><input align="left" hidden="0" name="DATA_14" style="width: 75px; text-align: left;" title="估计分摊费用" /></font></div>
			</td>
			<td style="border-width: 1pt 1.5pt 1pt 1pt; border-style: solid; border-color: black rgb(0, 0, 0) black black; padding: 1px; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;"><input class="CALC" name="DATA_15" prec="2" style="width: 103px;" title="估计总成本" value="估计折算工资+估计材料费用+估计分摊费用" /></font></div>
			</td>
		</tr>
		<tr style="min-height: 35px;">
			<td style="border-width: 1pt 1pt 1.5pt 1.5pt; border-style: solid; border-color: black black rgb(0, 0, 0) rgb(0, 0, 0); padding: 1px; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;">实际</font></div>
			</td>
			<td style="border-width: 1pt 1pt 1.5pt; border-style: solid; border-color: black black rgb(0, 0, 0); padding: 1px; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;"><input align="left" hidden="0" name="DATA_16" style="width: 60px; text-align: left;" title="实际开始日期" /><img _fcksavedurl="/module/html_editor/editor/images/calendar.gif" align="absMiddle" alt="" border="0" class="DATE" date_format="yyyy-MM-dd" name="DATA_27" src="/static/images/form/calendar.png" title="日期控件:实际开始日期" value="实际开始日期" /></font></div>
			</td>
			<td style="border-width: 1pt 1pt 1.5pt; border-style: solid; border-color: black black rgb(0, 0, 0); padding: 1px; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;"><input align="left" hidden="0" name="DATA_17" style="width: 60px; text-align: left;" title="实际完工日期" /><img _fcksavedurl="/module/html_editor/editor/images/calendar.gif" align="absMiddle" alt="" border="0" class="DATE" date_format="yyyy-MM-dd" name="DATA_28" src="/static/images/form/calendar.png" title="日期控件:实际完工日期" value="实际完工日期" /></font></div>
			</td>
			<td style="border-width: 1pt 1pt 1.5pt; border-style: solid; border-color: black black rgb(0, 0, 0); padding: 1px; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;"><input align="left" hidden="0" name="DATA_18" style="width: 75px; text-align: left;" title="实际总工时" /></font></div>
			</td>
			<td style="border-width: 1pt 1pt 1.5pt; border-style: solid; border-color: black black rgb(0, 0, 0); padding: 1px; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;"><input align="left" hidden="0" name="DATA_19" style="width: 75px; text-align: left;" title="实际折算工资" /></font></div>
			</td>
			<td style="border-width: 1pt 1pt 1.5pt; border-style: solid; border-color: black black rgb(0, 0, 0); padding: 1px; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;"><input align="left" hidden="0" name="DATA_20" style="width: 75px; text-align: left;" title="实际材料费用" /></font></div>
			</td>
			<td style="border-width: 1pt 1pt 1.5pt; border-style: solid; border-color: black black rgb(0, 0, 0); padding: 1px; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;"><input align="left" hidden="0" name="DATA_21" style="width: 75px; text-align: left;" title="实际分摊费用" /></font></div>
			</td>
			<td style="border-width: 1pt 1.5pt 1.5pt 1pt; border-style: solid; border-color: black rgb(0, 0, 0) rgb(0, 0, 0) black; padding: 1px; vertical-align: middle;">
			<div align="center"><font face="宋体" style="font-size: 11pt;"><input class="CALC" name="DATA_22" prec="2" style="width: 103px;" title="实际总成本" value="实际折算工资+实际材料费用+实际分摊费用" /></font></div>
			</td>
		</tr>
	</tbody>
</table>
</div>
