Audit

Location and Time of Inspection
Building Name
Date & Time
Maintenance Deficiency

Description of the Maintenance Discrepancy

Location

Description of the Maintenance Discrepancy

Location

Description of the Maintenance Discrepancy

Location

Description of the Maintenance Discrepancy

Location

Description of the Maintenance Discrepancy

Location

Description of the Maintenance Discrepancy

Location

Description of the Maintenance Discrepancy

Location

Urgency
Work needs to be completed by:

Follow-up Required

Follow-up is required:
Photos
Picture of the Maintenance Deficiency
Signature
Signature of Inspector
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.