Title Page
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Campus Location
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Conducted on
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Prepared by
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Employee Name:
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Room Location:
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Date Marked:
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Time Marked:
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Cleaning Type
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Date Inspected:
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Time Inspected:
Yes = Completely Removed / No = Appeared Untouched
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1. Door Plates
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2. OR Table
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3. OR Lights
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4. Phones
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5. Light Switch