Jason Russo

UNIT REPLACEMENT FORM

Use this Template

Print as PDF

Use this Template

Go digital today!

Convert your paper checklists into digital forms

Scan this QR code to use this paper checklist on your smartphone or tablet or visit https://safetyculture.com/

Title Page

TECHNICIAN NAME
STORE AND STORE NUMBER
LOCATION
LOCATION TYPE
IF MALL, IS HOTWORK PERMIT REQUIRED?
IF MALL, CONTACT INFORMATION FOR MALL PROPERTY MANAGEMENT
UNIT TYPE
UNIT NUMBER
UNIT BRAND
MODEL NUMBER
SERIAL NUMBER
PHASING AND VOLTAGE
PLEASE TAKE PICTURES/VIDEO OF ANY/ALL ISSUES WITH UNIT, AS WELL AS BRIEF DESCRIPTION
PLEASE TAKE PICTURES FROM BOTH CORNERS OF UNIT
PLEASE TAKE PICTURE OF ANY OBSTACLES/OBSTRUCTIONS FOR CRANE/TECHNICIANS
CURB DIMENSIONS (LxWxH)
CRANE DISTANCE FROM EDGE OF ROOF
CRANE - HEIGHT OF BUILDING
DISTANCE CRANE WOULD SET UP FROM SIDE OF BUILDING (ft.)

Jason Russo

UNIT REPLACEMENT FORM

Use this Template

Print as PDF

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.