Information

  • Document No.

  • Unit nr

  • Make

  • Model Number

  • Serial Number

  • Location Indoor

  • Location Outdoor

  • Conducted on

  • Inspection done by

Description

  • Is unit identified

  • Please supply detail of problem and possible solution:

  • Is asset/identification number legible

  • Please supply detail of problem and possible solution:

  • Is unit listed on register

  • Please supply detail of problem and possible solution:

  • Is unit listed on maintenance program

  • Please supply detail of problem and possible solution:

  • Covers not missing

  • Please supply detail of problem and possible solution:

  • Covers not broken

  • Please supply detail of problem and possible solution:

  • No missing screws or bolts

  • Please supply detail of problem and possible solution:

  • Thermostat is functioning

  • Please supply detail of problem and possible solution:

  • No gas leaks

  • Please supply detail of problem and possible solution:

  • Wiring not damaged

  • Please supply detail of problem and possible solution:

  • No bad joints in electrical cable

  • Please supply detail of problem and possible solution:

  • Filters clean

  • Please supply detail of problem and possible solution:

  • Date filter were cleaned

  • Plug is not damaged

  • Please supply detail of problem and possible solution:

  • Date of last repair

  • Outlets in office clean

  • Please supply detail of problem and possible solution:

  • Airflow in office adequate

  • Please supply detail of problem and possible solution:

  • Controller/Remote Working

  • Please supply detail of problem and possible solution:

SIGNATURE STATUS

  • Building Maintenance Representitive

  • Facilities Manager

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.