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Form Design Change Request

This document is a design field change request form containing 4 sections. Section 1 requests the design change and contains signatures for approval. Section 2 provides details of the requested change such as description and reason. Section 3 is for evaluation of whether a change order or major item is required. Section 4 is for final approval signatures from key roles such as Engineering Manager, Project Manager, Site Manager, and Company if required.

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Al Hamra Ayashofiya
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2K views1 page

Form Design Change Request

This document is a design field change request form containing 4 sections. Section 1 requests the design change and contains signatures for approval. Section 2 provides details of the requested change such as description and reason. Section 3 is for evaluation of whether a change order or major item is required. Section 4 is for final approval signatures from key roles such as Engineering Manager, Project Manager, Site Manager, and Company if required.

Uploaded by

Al Hamra Ayashofiya
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Design Field Change Request

Design Field Change No.


Subject of Design Change
Section-1 Request for Design Change (by Requester)

-1 Date Design Change Requested

-2 Discipline

Requester's Name Approved by


Title Title
Signature Signature

Section-2 Detail of Design Change (by Requester)

-1 Description of Design Change

Document No.

Rev No.
Item Line No.

-2 Reason of Change (1) Company Request (9) Function or Performance issues


(2) P&ID/HAZOP/HAZID (10) Revision for Safety
(3) Process Design Change (11) Revision for Operability
(4) Vendor's Design Change (12) Revision for Maintenance
(5) Vendor's Info Incorporation (13) CAD Error
(6) Release of Hold (14) Start Up Comment
(7) Piping Design Incorporation (15) Others (Engineering Development)
(8) Instrumentation Design Incorporation
comment/others: ___________________________________________________
___________________________________________________
___________________________________________________

-3 Impact to Other Facilities Design impact to other discipline ( ) Comments:


Rework required at site ( )
Impact to vendor
Schedule Cost
impact to subcontractor
Schedule Cost

Section-3 Evaluation (by Requester and FEM)

Requester (sign) EM (sign) CPY (sign) Final Check


Yes No Yes No Yes No (by EM)
-1 Change Order Required Major Change
-2 Major Item ? (Site office Required) Minor Change
-3 COMPANY's comment, if any:

Section-4 Approval (by EM, SM, PM, COMPANY)

-1 Approval of Engineering Manager Approved as Requested

Date PM Approval Required SM Approval Required

Signature Not Approved Company Approval Required

Reason:

-2 Approval of Project Manager


(if required)
Date Approved as Requested

Signature Not Approved

Reason:

-3 Approval of Site Manager


(if required)
Date Approved as Requested

Signature Not Approved

Reason:

-4 Approval of COMPANY
(if required)
Approved by Approved as Requested Not Approved
Title
Signature Reason:
Date

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