Civic Cincinnati
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Bench Check Form
Bus Stop Maintenance Check Form
Stop ID
*
4-digit number on the bottom right hand corner of the bus stop sign
Date of Maintenance Check
*
Bus Stop General Status
*
Please select the option that best describes the overall state of the bus stop.
Poor
Fair
Good
Excellent
Bench General Status
*
Please select the option that best describes the overall state of the bench.
Poor
Fair
Good
Excellent
Lock or Bench Missing
Status Notes
Please note any details about the bench or bus stop that might be helpful to document.
Maintenance Performed
Please select maintenance you performed, if any.
Lock cleaning
Lock repair
Lock replacement
Bench cleaning
Bench paint touchup
Bench full repaint
Bench repair
Bench removal
Trash pickup
Other
Photo
Please take a photo so that we can have a nice little log of the bench’s journey.
I will take a photo, Ern!
Other Remarks
Please note anything else you’d like to share (observations, suggestions, etc.).
Submit maintenance check
