Title Page

  • Conducted on

  • Prepared by


Maintenance Report

    Maintenance Issue
  • Location and description:

  • Image of affected area:

  • Is this a hazard?

  • Describe corrective action:

  • Image of corrective action:

  • Urgency assessment: (1 - cosmetic minor, 10 - hazard major/urgent)

  • Note corrective action, if taken:

  • Image of corrective action:

  • Completed:

  • Reporting person:

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