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Report Information
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Date of Report
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MM-DD-YEAR (i.e., 03-15-2013)
Round Information
Which Round?
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Time
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Please indicate am or pm
All doors are locked/access working?
Doors propped?
Stoves/Ovens
Dishes
Countertops/Tables
Bathrooms
Laundry Room (Clothes on floor?)
Computer Printer Station
Lounge areas (Is all furniture there?)
Fire extinguishers
Work Orders completed
Any situations confronted/Incident Reports written?