Title Page

  • Document No.

  • Maintenance

  • Business / Site

  • Conducted on

  • Prepared by:

  • Location
  • Personnel

Client/Business Information

  • Business/Organisation Name

  • Client Contact

  • Client/Business Address
  • Address where units are if different...
  • Email

  • Contact No.

Air Conditioning Survey

  • How Many Units:

  • Type of Units (e.g 2x coolers)

  • Fully working units (attach media)

  • Are all units in full working order? (If no please specify, attach media here)

  • Any visible barcodes

  • Date of Last Maintenance

  • Date of Last Filter Clean

  • Can we carry out Maintenance<br>If no, please specify

Confirmation of visit

  • Engineer Conducting Survey

  • Client on site

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