GS - F44 | Rev : 3

SITE :
ROUTINE SURVEILLANCE DATE
DATE BUILDING:
JOB STARTED LEVEL:
JOB COMPLETED LOCATION:

Wednesday

Thursday
Tuesday
Monday

Friday
No Task Description COMMENTS / REMARKS

1 LIGHTING

Office Area

Toilet

Lift Lobby

EXIT light

Staircase

Common Area

2 LIFT

Light

Air Ventillation

Travelling Comfort

Safety Features

Lift Car Panel

3 AIR-CONDITIONING

Comfortable

4 WATER TANK LEVEL

Cooling Tower

Domestic

5 TOILET

Toilet Facilities

Ventilation

6 CIVIL & STRUCTURE

Wall

Ceiling

Floor

Door

Window

7 HOUSEKEEPING

Rubbish Bin

Floor Cleanliness

Staircase
ACTION CODE
/ - GOOD X - PROBLEM NA - Not Applicable
VERIFICATION
Checked By : Verified By : Certified By :
Signature: Signature: Signature:

Name : Name : Name :

Date : Date : Date :