Asset Damage Form

ASSET DAMAGE REPORT

First name*

Last name*

Today's Date*

Asset Address/Location*

Client Name:

Asset Serial #*

Asset Type:

Asset Type*

Portable Toilet:

Dropdown

DAMAGE NOTES:

Repair or Replace?

Repair

Replace

Priority

High (Immediate Attention)

Low

File upload

HandWash Station:

Dropdown

DAMAGE NOTES:

Repair or Replace?

Repair

Replace

Priority

High (Immediate Attention)

Low

File upload

Holding Tank:

DAMAGE NOTES:

Repair or Replace?

Repair

Replace

Priority

High (Immediate Attention)

Low

File upload

Dumpster:

DAMAGE NOTES:

Repair or Replace?

Repair

Replace

Priority

High (Immediate Attention)

Low

File upload

Signature*

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By Signing I CERTIFY that ALL responses are TRUE & CORRECT.

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