---

Facility:	<%=FAC%>	System:	<%=SYS%>
Project:	<%=PROJ%>	SWR:	<%=SWR%>
Organization:	<%=ORG%>	Type of Change:	<%=TOC%>

---

Reason for Change:

<%=REASON%>

-Estimated Cost of Change-

Design Hours:	<%=DESIGNHOURS%>	Labor Hours:	<%=LABORHOURS%>
Materials:	<%=MATERIALS%>	Total Cost:	<%=TOTALCOST%>

---

Items Affected

	onclick='return false;' />	Hardware / Mechanical	onclick='return false;' />	Test / Checkout Procedures
	onclick='return false;' />	Electrical	onclick='return false;' />	Retest / Requalification
	onclick='return false;' />	Software	onclick='return false;' />	Facility Equipment
	onclick='return false;' />	Drawings	onclick='return false;' />	System Interfaces
	onclick='return false;' />	Technical Waivers	onclick='return false;' />	Hazards Analysis
	onclick='return false;' />	Documents (PRD / FCD)	onclick='return false;' />	Other: <%=OTHERTEXT%>
	onclick='return false;' />	Other ECRs / EOs

---

Reference Documents / Document Numbers :

<%=REF_DOC%>