Oskomera Site Damage Report

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

SITE DAMAGE REPORT

• Elevation

• Level

• Grid Reference

• WE HAVE NOTICED THE FOLLOWING DAMAGE AT THE ABOVE LOCATION, AND WE ARE AWAITING INSTRUCTION/PROCEEDINGS TO RECTIFY

• Item

• CORRECTIVE ACTION REQUIRED TO PREVENT FURTHER NON-COMPLIANCE

  Yes

  No

  N/A

• DATE BY WHICH TO BE ACTIONED

  Date

CAUSE OF DAMAGE

• Cause of Damage

• Photo of damage

  Media

• Date and time of damage

  Date

• Date damage was first noted

  Date

• Party Responsable

• Third party witness

• Damage witnessed by

• Company

• Report prepaired by Oskomera Manager

  Sign