Please check mark on one or more items below and fax back to us.
Please click here to down load a form to do survey;
| Customer site survey sheet | Please fax to: 845-5592 | Attn:_______________ | ||||
| Restroom areas | Common areas | Outside areas | ||||
| __ | Urinal, toilet | __ | Hallway carpet | __ | Pool deck | |
| __ | Tile | __ | Hallway hard floor | __ | Gum | |
| __ | Walls | __ | Natural stone | __ | Windows | |
| __ | Stainless steels | __ | Window | __ | Odor | |
| __ | Drains | __ | Odor | __ | Dumspters | |
| __ | Hard water stains | __ | Upholstery | __ | Slippery floor | |
| __ | Soap scum | __ | Slippery floor | __ | Matting | |
| __ | Odor | __ | Fixtures | __ | Fixturs | |
| __ | Slippery floor | __ | Dispensers | __ | Dispensers | |
| __ | Dispensers | __ | Wood floors | __ | Blood pathogen kit | |
| __ | Blood pathogen kit | __ | Laminated floors | __ | Parking lot grease | |
| __ | Matting | __ | __ | Insect repenllant | ||
| __ | __ | __ | Graffiti | |||
| Kitchen | Rooms | Other areas | ||||
| __ | Exhaust hood | __ | Mold & mildew | __ | ||
| __ | Tile | __ | Carpet & upholstery | __ | ||
| __ | Oven & grill | __ | Hard water spots | __ | ||
| __ | Smoke and odor | __ | Smoke and odor | __ | ||
| __ | Drain | __ | Grout | __ | ||
| __ | Rust stains | __ | Glass | __ | ||
| __ | Matting | __ | Lanai floor | __ | ||
| __ | Dispensers | __ | Dispensers | __ | ||
| __ | Slippery floors | __ | Blood pathogen kit | __ | ||
| Counter tops | ||||||
| Customer Name: | ____________________ | |||||
| Company name: | ____________________ | |||||
| Phone: | _____________________ | |||||
| Fax: | _____________________ | |||||
| Email address: | _____________________ | |||||
| Lamers Enterprise, Inc 251 Puuhale Rd, Honolulu, Hi 96819 | Ph: 808-845-9365, Fax: 808-845-5592 |
