Title Page
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If the building name is not in the list, type the building name.
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Conducted on
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Date of Service
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Building serviced by:
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Who is the lead technician?
End of Job Report
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Did any damage occur during Service
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What damage occurred?
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Did anyone onsite have a near miss or an accident?
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What was the near miss or incident
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Was This reported to your supervisor?
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Any access or issues identified or experienced onsite during works?
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Please explain the issue or access issue
Before and After Pictures
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Choose the service facilitated on the Roof
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Was the Roof service completed?
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Why was the roof service not completed?
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Roof Wash/Treatment before and After Photos - (Supply at least 5 of each before and after photos)
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Was the building wash completed?
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Why was the building wash not completed?
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Building Wash Before and After Photos - (Supply at least 8 of each before and after photo's)
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Was the gutter cleaned?
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Why was the gutter not cleaned?
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Gutter Before and After Photos (supply at least 2 of each before and after photos)
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Any additional notes regarding building and works to be considered in future?
Building Defects - Supply notes and any evidence of defects noted on the building ie. staining, loose panels, rust etc.
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Did you find any defects on the building?
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What are the defects?
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Photos of defects with notes:
![2019 Food Safety Verification [Version 1-14-19]](/media/07d47d6a-ec94-4937-bec6-82958e2de0ad "2019 Food Safety Verification [Version 1-14-19]")
