Corrective Maintenance Record Work Order # ______________________ Date Issued _____________ Issue to be resolved: (e.g., damaged cap) The issue was from Corresponding Checklist No. ________, Component No. (e.g., A Dry Well), Inspection Item No. (e.g., 2, 3) . – Required Actions Actions Planned Date Date Completed Repair cap Repair perforated pipe Repair fabric Repair bypass pipe Repair downspout (If there are additional tasks, list them here.) Responsible person(s): ________________________________________________________ Special requirements Time of the season or weather condition:_________________________ Tools/equipment:____________________________________________ Subcontractor (name or specific type):___________________________ Approved by ___________________/_______________ Date _____________ (name/signature) Verification of completion by ____________/________ Date _____________ (name/signature) File this Corrective Maintenance Record in the Maintenance Log after performing maintenance.
Corrective Maintenance Record Work Order # ______________________ Date Issued _____________ Issue to be resolved: (e.g., damaged cap) The issue was from Corresponding Checklist No. ________, Component No. (e.g., A – Dry Well), Inspection Item No. (e.g., 2, 3) . Required Actions Actions Planned Date Date Completed Repair cap Repair perforated pipe Repair fabric Repair bypass pipe Repair downspout (If there are additional tasks, list them here.) Responsible person(s): ________________________________________________________ Special requirements Time of the season or weather condition:_________________________ Tools/equipment:____________________________________________ Subcontractor (name or specific type):___________________________ Approved by ___________________/_______________ Date _____________ (name/signature) Verification of completion by ____________/________ Date _____________ (name/signature) File this Corrective Maintenance Record in the Maintenance Log after performing maintenance.
11-dry-well-main-field-manual-apr-2015.docx