|
|
|
Please note that all required fields are highlighted in red.
|
|
Today's Date:
|
|
RPTG Marks:
|
|
|
Contact:
|
|
Car Number:
|
|
|
Company:
|
|
Commodity:
|
|
|
Phone:
|
|
Gasket & O-Ring
(N/A for Hopper):
|
|
|
Fax:
|
|
STCC or UN:
|
|
|
Email:
|
|
Clean Status:
|
|
|
Present Railroad:
|
|
Empty or Loaded:
|
|
|
Present Location:
|
|
Amount of Heel:
|
|
|
Preferred Repair Shop:
|
|
Reason for Shopping:
|
|
|
Other Repair Shop:
|
|
Continue Lease Y/N:
|
|
|
Repair Shop Railroad:
|
|
Return Disposition:
|
|
|
|
Disposition Railroad:
|
|
Submit Request to:
|