Title Page
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Conducted on
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Prepared by
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Site Name
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E maintenance/City ref: ( Job number )
Type of condemned equipment
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Make
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Model
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Serial Number
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Please provide reason for condemnation ( Give as much detail as possible.)
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Please provide photo's including serial number.
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Do you have any comments or recommendations?
MANAGER COMMENTS (to enter notes and pictures, select the space under the option to open up the fields)
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Confirm you have spoken to the manager (or their deputy) and agreed a course of action
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Add here comments from the manager (or their deputy)
SIGNATURES
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Signature of Tech:
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Signature of the Site Manager (deputy):