Information

  • Document No.

  • Client / Site

  • Conducted on

  • Location
  • Personnel

  • Time of arrival

  • Time of departure

  • Travel Time

System Checks

  • Are there any existing Faults

  • Is the system Monitored

  • Did all devices test ok?

  • What is the described fault

  • Is there any sign of damage

  • Is the Job Complete and fully operational

Parts required for repair

  • Are replacement parts required

  • What parts are required to repair fault

  • Have replacement Parts been installed

  • What Parts have been used

Customer Acceptance

  • I agree

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Job completion

  • I hereby certify that the works described above have been carried out and have been completed to my satisfaction. I agree that any outstanding works have been explained and I agree to arrange for any outstanding or further works described under the "Further action required by client" section above to be carried out. I also undertake to ensure payment of any applicable charges. Current standard charges plus any parts costs.

Additional information

  • Take pictures of serial numbers or Written note below

  • Is System clear of faults

  • What fault or faults exist

  • Picture Reference main System

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.