Information
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Audit Title
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Inspection Number
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Date and Time of Inspection
Inspection Information
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Building Number: TX3003ZZ
Building Name: The Wide Field Building
Building Address: 1234 Main Street Dallas, TX 75242
Contract No: GSP-09-HF521600
Contracting Officer: Jane Doe Smith
Contracting Officer's Representative (COR): James Thomas
Maintenance Contractor: XYZ Contractors -
Inspection Number
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Date of Inspection
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Name of Inspector
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Is inspector a GSA associate?
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Inspector's signature
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Maintenance Contractor's Representative
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Maintenance Contractor's Representative Signature
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*All deficiencies must be recorded promptly by the maintenance contractor in GSA’s Computerized Maintenance Management System (CMMS).
Inspection Items 1 - 10
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Inspection Item 1
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LOCATION (Mechanical area, floor, room number)
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TYPE OF EQUIPMENT
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EQUIPMENT NUMBER
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Is the equipment or area in a satisfactory condition?
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Do current conditions pose a risk to life, safety or property?
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Do current conditions affect the efficiency of building systems?
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COMMENTS
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INSERT PHOTOS HERE
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INITIAL AND DATE CORRECTED
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Inspection Item 2
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LOCATION (Mechanical area, floor, room number)
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TYPE OF EQUIPMENT
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EQUIPMENT NUMBER
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Is the equipment or area in a satisfactory condition?
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Do current conditions pose a risk to life, safety or property?
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Do current conditions affect the efficiency of building systems?
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COMMENTS
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INSERT PHOTOS HERE
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INITIAL AND DATE CORRECTED
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Inspection Item 3
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LOCATION (Mechanical area, floor, room number)
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TYPE OF EQUIPMENT
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EQUIPMENT NUMBER
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Is the equipment or area in a satisfactory condition?
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Do current conditions pose a risk to life, safety or property?
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Do current conditions affect the efficiency of building systems?
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COMMENTS
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INSERT PHOTOS HERE
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INITIAL AND DATE CORRECTED
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Inspection Item 4
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LOCATION (Mechanical area, floor, room number)
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TYPE OF EQUIPMENT
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EQUIPMENT NUMBER
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Is the equipment or area in a satisfactory condition?
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Do current conditions pose a risk to life, safety or property?
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Do current conditions affect the efficiency of building systems?
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COMMENTS
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INSERT PHOTOS HERE
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INITIAL AND DATE CORRECTED
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Inspection Item 5
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LOCATION (Mechanical area, floor, room number)
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TYPE OF EQUIPMENT
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EQUIPMENT NUMBER
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Is the equipment or area in a satisfactory condition?
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Do current conditions pose a risk to life, safety or property?
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Do current conditions affect the efficiency of building systems?
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COMMENTS
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INSERT PHOTOS HERE
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INITIAL AND DATE CORRECTED
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Inspection Item 6
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LOCATION (Mechanical area, floor, room number)
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TYPE OF EQUIPMENT
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EQUIPMENT NUMBER
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Is the equipment or area in a satisfactory condition?
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Do current conditions pose a risk to life, safety or property?
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Do current conditions affect the efficiency of building systems?
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COMMENTS
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INSERT PHOTOS HERE
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INITIAL AND DATE CORRECTED
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Inspection Item 7
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LOCATION (Mechanical area, floor, room number)
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TYPE OF EQUIPMENT
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EQUIPMENT NUMBER
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Is the equipment or area in a satisfactory condition?
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Do current conditions pose a risk to life, safety or property?
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Do current conditions affect the efficiency of building systems?
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COMMENTS
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INSERT PHOTOS HERE
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INITIAL AND DATE CORRECTED
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Inspection Item 8
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LOCATION (Mechanical area, floor, room number)
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TYPE OF EQUIPMENT
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EQUIPMENT NUMBER
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Is the equipment or area in a satisfactory condition?
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Do current conditions pose a risk to life, safety or property?
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Do current conditions affect the efficiency of building systems?
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COMMENTS
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INSERT PHOTOS HERE
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INITIAL AND DATE CORRECTED
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Inspection Item 9
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LOCATION (Mechanical area, floor, room number)
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TYPE OF EQUIPMENT
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EQUIPMENT NUMBER
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Is the equipment or area in a satisfactory condition?
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Do current conditions pose a risk to life, safety or property?
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Do current conditions affect the efficiency of building systems?
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COMMENTS
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INSERT PHOTOS HERE
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INITIAL AND DATE CORRECTED
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Inspection Item 10
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LOCATION (Mechanical area, floor, room number)
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TYPE OF EQUIPMENT
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EQUIPMENT NUMBER
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Is the equipment or area in a satisfactory condition?
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Do current conditions pose a risk to life, safety or property?
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Do current conditions affect the efficiency of building systems?
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COMMENTS
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INSERT PHOTOS HERE
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INITIAL AND DATE CORRECTED
Inspection Items 11 - 20
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Inspection Item 11
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LOCATION (Mechanical area, floor, room number)
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TYPE OF EQUIPMENT
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EQUIPMENT NUMBER
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Is the equipment or area in a satisfactory condition?
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Do current conditions pose a risk to life, safety or property?
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Do current conditions affect the efficiency of building systems?
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COMMENTS
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INSERT PHOTOS HERE
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INITIAL AND DATE CORRECTED
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Inspection Item 12
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LOCATION (Mechanical area, floor, room number)
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TYPE OF EQUIPMENT
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EQUIPMENT NUMBER
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Is the equipment or area in a satisfactory condition?
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Do current conditions pose a risk to life, safety or property?
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Do current conditions affect the efficiency of building systems?
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COMMENTS
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INSERT PHOTOS HERE
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INITIAL AND DATE CORRECTED
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Inspection Item 13
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LOCATION (Mechanical area, floor, room number)
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TYPE OF EQUIPMENT
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EQUIPMENT NUMBER
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Is the equipment or area in a satisfactory condition?
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Do current conditions pose a risk to life, safety or property?
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Do current conditions affect the efficiency of building systems?
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COMMENTS
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INSERT PHOTOS HERE
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INITIAL AND DATE CORRECTED
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Inspection Item 14
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LOCATION (Mechanical area, floor, room number)
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TYPE OF EQUIPMENT
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EQUIPMENT NUMBER
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Is the equipment or area in a satisfactory condition?
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Do current conditions pose a risk to life, safety or property?
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Do current conditions affect the efficiency of building systems?
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COMMENTS
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INSERT PHOTOS HERE
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INITIAL AND DATE CORRECTED
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Inspection Item 15
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LOCATION (Mechanical area, floor, room number)
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TYPE OF EQUIPMENT
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EQUIPMENT NUMBER
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Is the equipment or area in a satisfactory condition?
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Do current conditions pose a risk to life, safety or property?
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Do current conditions affect the efficiency of building systems?
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COMMENTS
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INSERT PHOTOS HERE
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INITIAL AND DATE CORRECTED
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Inspection Item 16
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LOCATION (Mechanical area, floor, room number)
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TYPE OF EQUIPMENT
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EQUIPMENT NUMBER
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Is the equipment or area in a satisfactory condition?
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Do current conditions pose a risk to life, safety or property?
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Do current conditions affect the efficiency of building systems?
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COMMENTS
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INSERT PHOTOS HERE
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INITIAL AND DATE CORRECTED
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Inspection Item 17
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LOCATION (Mechanical area, floor, room number)
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TYPE OF EQUIPMENT
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EQUIPMENT NUMBER
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Is the equipment or area in a satisfactory condition?
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Do current conditions pose a risk to life, safety or property?
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Do current conditions affect the efficiency of building systems?
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COMMENTS
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INSERT PHOTOS HERE
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INITIAL AND DATE CORRECTED
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Inspection Item 18
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LOCATION (Mechanical area, floor, room number)
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TYPE OF EQUIPMENT
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EQUIPMENT NUMBER
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Is the equipment or area in a satisfactory condition?
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Do current conditions pose a risk to life, safety or property?
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Do current conditions affect the efficiency of building systems?
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COMMENTS
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INSERT PHOTOS HERE
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INITIAL AND DATE CORRECTED
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Inspection Item 19
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LOCATION (Mechanical area, floor, room number)
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TYPE OF EQUIPMENT
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EQUIPMENT NUMBER
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Is the equipment or area in a satisfactory condition?
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Do current conditions pose a risk to life, safety or property?
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Do current conditions affect the efficiency of building systems?
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COMMENTS
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INSERT PHOTOS HERE
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INITIAL AND DATE CORRECTED
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Inspection Item 20
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LOCATION (Mechanical area, floor, room number)
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TYPE OF EQUIPMENT
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EQUIPMENT NUMBER
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Is the equipment or area in a satisfactory condition?
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Do current conditions pose a risk to life, safety or property?
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Do current conditions affect the efficiency of building systems?
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COMMENTS
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INSERT PHOTOS HERE
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INITIAL AND DATE CORRECTED
