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Maintenance Sheet

Location (adress) ?*

Location (adress) ?*

Contact at Helexia (name, email and phone number) ?*

Contact at Helexia (name, email and phone number) ?*

Contact at HM (name, email and phone number) ?*

Contact at HM (name, email and phone number) ?*

Valid until ?*

Valid until ?*

Number of interventions ?*

Number of interventions ?*

Please make appointments 1week in advance by email

Company name ?*

Company name ?*

Your informations (Name, surname, phone number)*

Your informations (Name, surname, phone number)*

HM Safety ?*

HM Safety ?*

VCA ?*

VCA ?*

Hoisting certificate*

Hoisting certificate*

PPE*

PPE*

Please add your signature(s)*

Please add your signature(s)*

This type of file isn't allowed
The file size must be up to 100 MB

Name of the roof ?*

Name of the roof ?*

Height of the roof ?*

Height of the roof ?*

Type of the roof ?*

Type of the roof ?*

Please add a picture of the roof*

Please add a picture of the roof*

This type of file isn't allowed
The file size must be up to 100 MB

Orientation of the roof ?*

Orientation of the roof ?*

Number of panels ?*

Number of panels ?*

Type of cleaning ?*

Type of cleaning ?*

Type of roof access ?*

Type of roof access ?*

Please add a picture of the roof access*

Please add a picture of the roof access*

This type of file isn't allowed
The file size must be up to 100 MB

Type of roof security ?*

Type of roof security ?*

Access to the roof needed ?*

Access to the roof needed ?*

PPE needed ? If yes, specify.*

PPE needed ? If yes, specify.*

Please add a picture of the water access*

Please add a picture of the water access*

This type of file isn't allowed
The file size must be up to 100 MB

Distance water access-roof ?*

Distance water access-roof ?*

Type of connection ?*

Type of connection ?*

Road protection needed ?*

Road protection needed ?*

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