M.O.M. EQUIPMENT SERVICE Inspection Sheet If no device present, check NA otherwise all boxes to be checked IAQ MOM Services Questionnaire Job Number / Name: * Sump Pump Sump Pump * Yes N/A Date Last Inspected * Make / Model * Did Client Send in the Warranty Information? * Yes No TEST DRIVE FLOAT SWITCH TESTED PUMP TESTED ODOR CHECKED WATER LEAK CHECKED DISCHARGE PIPE CHECKED EXTERIOR CASING CHECKED SUMP PIT CHECKED UPDATE SERVICE LABEL Yes No Dehumidifier Dehumidifier * Yes N/A Date Last Inspected * Make / Model * Did Client Send in the Warranty Information? * Yes No TEST DRIVE HUMIDITY SETTING PUMP TESTED FILTERS CHECKED REPLACED PRIMARY Yes No REPLACED SECONDARY Yes No COIL CLEANSED UPDATE SERVICE LABEL Yes No CLIENT WILL BE BILLED FOR FILTERS: Primary $ Secondary $ VENTILATOR INSPECTION: VENTILATOR INSPECTION: Yes No Date Last Inspected MAKE / MODEL NO Did Client Send in the Warranty Information? Yes No TEST DRIVE WINTER SETTING SUMMER SETTING EXHAUST Passive VENTS UPDATE SERVICE LABEL Email * Phone If you are human, leave this field blank. Submit Δ
