Facility Trouble Sheet

The LAC Trouble Sheet, reproduced below, was designed by Frank L. Christ, Director of the LAC at CSU Long Beach to monitor problems that can and do occur in a LAC. The trouble sheets are distributed to all LAC staff. After a problem is noted, copies of this NCR form go to the Director and to the Facility Supervisor. When the Facility Supervisor takes appropriate action and records it on the form, it is returned to the Director. Forms are numbered. [Form may be adapted for use freely]

LAC TROUBLE SHEET No.##

Reported by _____________________ Date_______________

[ ] Materials Problem       ____________________________________________________________________                                                           (title)                        (problem)
                                                                                                                          
[ ] Equipment Problem ______________________________________________________________________                                                              (type)                   (location)                         (problem)

 

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ACTION________________________________________________________________________________

TAKEN By_______________________ Date______________

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