ConServ building Services- VAN STOCK AND PICTURES - Service

• Conducted on

  Date

• Prepared by

• Location
  Address

• 28FT LADDER

  Yes

  No

  N/A

• 12FT

  Yes

  No

  N/A

• 10FT

  Yes

  No

  N/A

• 8FT

  Yes

  No

  N/A

• 6FT

  Yes

  No

  N/A

• LITTLE GIANT

  Yes

  No

  N/A

• TORCH SET WITH BOTTLES

  Yes

  No

  N/A

• ACETYLENE BOTTLES

  Yes

  No

  N/A

• HOW MANY?

• OXYGEN BOTTLES

  Yes

  No

  N/A

• HOW MANY?

• NITROGEN BOTTLES

  Yes

  No

  N/A

• HOW MANY?

• NITROGEN REGULATOR

  Yes

  No

  N/A

• RECLAIM MACHINE

  Yes

  No

  N/A

• 50# RECOVER TANK

  Yes

  No

  N/A

• HOW MANY?

• 30# RECOVER TANK

  Yes

  No

  N/A

• HOW MANY?

• POWER CORD

  Yes

  No

  N/A

• GFI

  Yes

  No

  N/A

• SHOP VAC

  Yes

  No

  N/A

• COME ALONG

  Yes

  No

  N/A

• PUMP SPRAYER

  Yes

  No

  N/A

• POWER WASHER

  Yes

  No

  N/A

• HOSE

  Yes

  No

  N/A

• HOW MANY FEET

• BACK PACK

  Yes

  No

  N/A

SAFETY SUPPLIES

• LOCK OUT TAG OUT "LOTO"

  Yes

  No

  N/A

• ROADSIDE KIT

  Yes

  No

  N/A

• FIRST AID KIT

  Yes

  No

  N/A

• 100FT SAFETY ROPE

  Yes

  No

  N/A

• Hard Hat

  Yes

  No

  N/A

• Cut 4 Gloves

  Yes

  No

  N/A

• Bump Cap

  Yes

  No

  N/A

• Safety Vest

  Yes

  No

  N/A

• FALL PROTECTION HARNESSES

  Yes

  No

  N/A

• LANYARD

  Yes

  No

  N/A

• RETRACTABLE LANYARD

  Yes

  No

  N/A

• CROSS ARM STRAP

  Yes

  No

  N/A

• FIRE EXTINGUISHER

  Yes

  No

  N/A

• HOW MANY?

VEHICLE INFO

• MAKE

• MODEL

• VIN#

• MILEAGE

• IS VAN CLEAN "INSIDE & OUT"??

  Yes

  No

  N/A

• GAS CARD

  Yes

  No

  N/A

• INSURANCE CARD

  Yes

  No

  N/A

• REGISTRATION

  Yes

  No

  N/A

• BLUETOOTH "HANDS FREE" SET

  Yes

  No

  N/A

• PICTURE FRONT OF VEHICLE

  Media

• ANY DAMAGE?

• PICTURE DRIVERS SIDE VEHICLE

  Media

• ANY DAMAGE?

• PICTURE PASSANGER SIDE VEHICLE

  Media

• ANY DAMAGE?

• PICTURE BACK OF VEHICLE

  Media

• ANY DAMAGE?