Information
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Client Name
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Facility Address
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Document No.
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Conducted on
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Inspection By
- Brad Pierson
- Brent Lee
- Curt Cogan
- Jeff Jarboe
- Josh Gearries
- Luther Smith
- Scott Suter
- Troy Burkett
Existing Conditions
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Specific Deficiency Identifier (if applicable)
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Deficiency location (floor, room number, etc...)
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Room Location on Drawing (if applicable)
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Life Safety Deficiency
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Existing Life Safety Deficiency Photo
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Suggested Required Actions
Deficiency Resolution
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Action Taken
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Final Condition Photo
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Date of Completion
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Report completed and sent to client
