Semiannual Safety and Maintenance Update

Please complete the following checklist and note any safety or maintenance problems in your unit or on the premises.
Please describe the specific problems and the rooms or areas involved. Here are some examples of the types of things we want to know about: garage roof leaks, excessive mildew in rear bedroom closet, fuses blow out frequently, door lock sticks, water comes out too hot in shower, exhaust fan above stove doesn't work, smoke alarm malfunctions, peeling paint, and mice in basement. Please point out any potential safety and security problems in the neighborhood and anything you consider a serious nuisance.
Please indicate the approximate date when you first noticed the problem and list any other recommendations or suggestions for improvement.
Please return this form with this month's rent check. Thank you. -- The Management
Name: ______________________________________________
Address:	__________________________________ __________________________________
Please indicate (and explain below) problems with:
[   ] Floors and floor coverings ______________________________________
[   ] Walls and ceilings ____________________________________________
[   ] Windows, screens, and doors ____________________________________
[   ] Window coverings (drapes, miniblinds, etc.) ________________________
[   ] Electrical system and light fixtures ________________________________
[   ] Plumbing (sinks, bathtub, shower, or toilet) __________________________
[   ] Heating or air conditioning system ________________________________
[   ] Major appliances (stove, oven, dishwasher, refrigerator) _______________
[   ] Basement or attic _____________________________________________
[   ] Locks or security system _______________________________________
[   ] Smoke detector ______________________________________________
[   ] Fireplace ___________________________________________________
[   ] Cupboards, cabinets, and closets _________________________________
[   ] Furnishings (table, bed, mirrors, chairs) ____________________________
[   ] Laundry facilities ____________________________________________
[   ] Elevator ___________________________________________________
[   ] Stairs and handrails __________________________________________
[   ] Hallway, lobby, and common areas _______________________________
[   ] Garage ____________________________________________________
[   ] Patio, terrace, or deck _________________________________________
[   ] Lawn, fences, and grounds _____________________________________
[   ] Pool and recreational facilities __________________________________
[   ] Roof, exterior walls, and other structural elements ___________________
[   ] Driveway and sidewalks _______________________________________
[   ] Neighborhood _______________________________________________
[   ] Nuisances __________________________________________________
[   ] Other ______________________________________________________

Specifics of problems: __________________________________________
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Other comments: _______________________________________________
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___________________________________________________ 	_______________ Tenant 	Date
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FOR MANAGEMENT USE
Action/Response:
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___________________________________________________ 	_______________	 Landlord/Manager 	Date