Area Rug Yes Or No

By | November 8, 2015

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$101.99


Description:

Rug Cleaning Pre-Wash Inspection Checklist . Rug Fiber Type: _____ Rug Construction Type/Size: _____ Rug Dye Test Results: _____ Visible Fringe Problems? Yes → No ↓ ← c. If yes: Torn? Weak

O Yes, continue to Step 5. o No, press bottom button then, press “Reset” again. Is there a RED LIGHT on the GFCI plug now? o Yes, continue installation of your RugBuddy™ panel under your area rug as directed. o No

Yes / No Area Rug: Synthetic / Wool / Silk / Repair / Padding replacement / Padding cleaning / Fringing / Dry cleaning Area Rug Pickup: Yes / No Upholstery Cleaning: Yes / No Upholstery: leather / Suede / velvet / Dry cleaning / Mattress

Yes / No Conditions noted upon initial inspection include, but are not limited to (upon closer scrutiny): AREA RUG INSPECTED BY (P RINT NAME) INVOICE # TRUCK # Area Rug _____ of_____ Delivery Info: Furniture to be moved

Yes No Comments Section may be used to clarify a response given, area rug, wiped up spilled liquid, called in work order, DMHDDAS Incident Report and Peer to Peer with No or Minor Injury Investigation Review Audit Tool Instructions-Effective 11/1/08 -Page 6 of 6 Standard for Risk

PATIENT IDENTIFICATION AREA Demographic Data Page 1 of 7 MEDICAL RECORD COPY Patient Name: DOB: Date: Address: Yes No If so, when and where: Skin test results: Previous Allergy Injections? Area rug: Wall to Wall: Air conditioning: Central Separate units Humidifi er: Animals in home:

FURNITURE: YES NO C – AREA RUG All orders are final and can not be changed. Broadloom orders will be seamed as per floor plans. By signing below you have read the above and are proceeding with the order. broadloom order form

Large area rug Young Children Present Yes No Coffee, hot liquids, and foods Out of child’s reach

(pile area): Maximum weft Icngth (pile area): Shape ratio: _ _ decimal Rug No.: _ Veft Fiber: Color: _ Not original: Fiber: _ Foundation weft is overcasting: yes no _ Selvage weft penetrates foundation: yes no _ Colors and design: _ Number of warps or warp bundles: _ Whip stitch

Stove: Stainless Yes No Condition: New Good Average Fair Brand Area Rug: _____X David Campbell Broker/Owner 34 S Federal Highway Dania Florida 33004 Ph:

Title: Retail Carpet Recycling Options in Wisconsin Author: Wisconsin DNR Subject: Carpet Recyclers Keywords: recycling, carpet, retail, retailers, recycling options

Allergy and Asthma Home Visit Checklist ___ Living Areas ___ Area Rug ___ Level Loop ___ Shag/Plush • Yes No Is the home located in an area that is known to have radon present? Show radon map. • Yes No If Yes,

Justification: Number Decorative Functional Organic Inorganic Principles Elements PS1a Yes No No Yes rhythm/harmony pattern PS1b Yes Yes:kids can

25 inches width: 2 inches Yes No 1b. length: 20 inches width: 5 inches Yes No 1c. length: 17 inches width: 8 inches Yes No 1d. length: 15 inches width: 5 inches area rug on his floor that is 7 feet long and 5 feet wide. Which statement tells how to find the amount of the floor that

Skilled Nursing Facility Prospective Payment System (RUG-IV), which reflects updated staff time measurement data derived from the Staff YES NO Refer to Chart B. Not included in CB. Bill Medicare Administrative Contractor (MAC).

Heating Yes No HEPA air filter Flooring Hardwood/Tile/Linoleum Small area rug Large area rug and model Pediatric Environmental History Form and The Center for Healthy Homes and Neighborhoods at Boston University

Yes No Comments Section may be used to clarify a response given, area rug, wiped up spilled liquid, called in work order, DMHDDAS Incident Report and Peer to Peer with No or Minor Injury Investigation Review Audit Tool Instructions-Effective 11/1/08 -Page 6 of 6 Standard for Risk

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