Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

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

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.