Title Page
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Customer Name
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Assessment Number
Listed Asset?
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Conducted on
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Name of Supervisor
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Location
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Name of Technician
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Date PM/CM/Install was done
Inspection Report
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Is this a servicing inspection (PM)?
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What is/are the unit type(s)?
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What is the number and types of units as per contract?
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What is the sample size assessment?
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Location of assessed units
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Notes / Issues / Concerns re job execution/quality
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Is this an installation inspection (Install)
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What type(s) of units were installed?
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Unit(s) size and brand
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What is the sample size assessment?
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Location of assessed unit(s)
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Notes / Issues / Concerns re job execution/quality
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Is this a repairs (corrective maintenance) inspection?
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What is the repair type?
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Specify repair type
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What type of equipment was worked on?
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Location and size of assessed unit(s)
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Notes / Issues / Concerns re job execution/quality
Summary
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Client Signature
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Time technician took to complete job
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Tools technician has for job execution
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Technician's competency level re job execution
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Training recommendation for technician
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Comments / Concerns
