Laundry Service Form

Distributor: *

Customer Information:

Business Name *

Name *

Address *

Address 2

City *

State *

Zip *

Phone *

Date: *

Time: *

Location:

Water Hardness:

Iron / Chlorine:

Dispensers:

Lint Traps:

Equipment Check

	Machine 1	Machine 2	Machine 3	Machine 4
Water Levels
Gages
Temperatures
Extract
Drain Valves
Formulas / Timer Cards
Wash Count

Training Done This Call:

  Showed Correct Pre-Sorting Procedures
  Showed Proper Use of Supplies
  Showed Wash Machine Loading Procedures
  Showed Proper Linen Handling - Folding Procedures

Inventory *

Product & Size	Qty.

Linen Section

1. Appearance:
2. Stain Removal:
3. Absorption:
4. Final pH:
5. Odor:
6. Feel:
7. Wrinkling:
8. Tensile Strength:

Action Taken:

Technician Signature: *	Technician Email:
Customer Signature: *
Send Copy to Bob St. Martin