Maintenance/ Repair Request
Employee name
*
First Name
Last Name
Phone Number in case more information is needed.
*
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Area Code
Phone Number
Today's Date
*
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Month
-
Day
Year
Date
What machine needs maintenance?
*
Describe the problem. What do you see or hear and what is the location on the machine if known?
*
If necessary, please take a picture of the part of the machine that is visibly broken or not working properly.
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