Service Report
1300 JAYCHEM (1300 529 243)
Site Name
SERVICE TECHNICIAN
ADDRESS
DATE
DEPARTMENT
ARRIVAL
CONTACT NAME
DEPARTURE
POSITION
PM OR EMERGENCY
PHONE NO.
DISPENSER TYPE
CUSTOMER EMAIL
CHEMICAL DISINFECTION AS4146
REPRESENTATIVE
Email
PHONE NUMBER
LAUNDRY MACHINE MAKE/MODEL
MACHINE SIZE
WASH CLASSIFICATIONS
WASH COUNT
TITRATION ALK (PPM)
BLEACH (PPM)
PH (FINAL RINSE)
PERSONALS
WHITES
TOWELS
SHEETS
INFECTIOUS
CLEANING RAGS
WOOLENS
CONDITION FOUND
EFFECTS ON RESULTS
CORRECTIONS/RECOMMENDATIONS
CHEMICAL MIXING STATION
FUNCTIONAL TEST
OBSERVATIONS
LABELLING
WASH CHARTS
WALL CHARTS
SDS
PRODUCT
QTY
BASED ON YOUR SERVICE TODAY, WOULD YOU RECOMMEND JAYCHEM TO A FRIEND OR COLLEAGUE? (1 = LOW, 10 = HIGH)
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