Marlin Hana

Repairs & Maintenance

Use this form to enter all the issues you find during your weekly in store visits. Click the “Add” button and enumerate and describe all the issues you find. You can take photos to be included in your reports. Once completed please email a report to you Operations Manager for follow up.

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Title Page

Store Name & ID
Conducted on
Prepared by

Are these repairs urgent?

Requested R&M's

Please describe the issue.
Add photos
Please describe the issue
Add photos
Please describe the issue
Photo (optional)
Electrical Equipment
Please describe the issue
Photo (optional)

Completion

Name and signature:

Marlin Hana

Repairs & Maintenance

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The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.