Building and Grounds Maintenance Request

Stephens County Department Heads (or designated representative) are required to use this form for all normal maintenance requested on buildings, buildings equipment, and/or grounds. In the event of an emergency situation or computer access is unavailable; it is permissible to call Building and Grounds Maintenance Director (in this event); please submit this form ASAP as a follow-up and record of maintenance activity.

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Date Problem Noticed: *
Time Problem Noticed:
Please enter the exact location where the problem was noticed
Location: *
Nature of Problem: *
Details: Please enter any further details that will help identify where the problem is located, who may be responsible, or why it may be occurring.

You may enter your name and address, but it is not required. However, if you would like a personal response, please provide your email address, a daytime phone number or a postal mailing address.

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