Educational Facility Survey

Please complete the form below in it's entirety. We will be in contact with you to review the results

• Contact & Facility Information

• Facility Name*
• City*
• State*
• Contact Name*
• Phone Number*
• email*
• Analysis Date
   - Month  - Day Year    

• Areas To Clean

• Classroom - Average number per school type

  	Elementary School	Middle School	High School
  # of classrooms w/ desks - hard floor
  # of classrooms w/ desks - carpet
  # of classrooms w/ lab tables - hard floor
  # of classrooms w/ bathrooms

• Restrooms (stand alone, not in a classroom) - Average number per school type

  	Elementary School	Middle School	High School
  # of restrooms - floor cleaning
  Average # of stalls & urinals per restroom

• Hallways - Average number per school type

  	Elementary School	Middle School	High School
  # of hallways with lockers - hard floor
  # of entryways - hard floor
  # of stairwells - hard floor

• Cafeteria - Average number per school type

  	Elementary School	Middle School	High School
  # of cafeteria tables - table & bench cleaning
  # of table on hard surface - floor cleaning
  Buffet table & lines

• Gymnasium - Average number per school type

  	Elementary School	Middle School	High School
  # of basketball courts w/ hardwood floor
  # of bleacher rows per basketball court
  # of locker rooms - floor cleaning
  Average # of shower heads per room
  # of coach's offices

• Worker & Facility Information

  	Elementary School	Middle School	High School
  # of schools in district
  Average # of workers to clean each facility
  Average worker wage / hour
  PAR (laundry) - # of sets of mops on hand
  Facility cleaning frequency / Day
  Facility cleaning days / Week
  Facility cleaning weeks / Year
  Gallons of water used per bucket (current system)
  Cost / Gallon Cleaning Chemical (undiluted)
  Cleaning Chemical Dilution (ounces) / Gallon of Water
  Water cost / gallon - inbound (fresh water)
  Water cost / gallon - discharge (gray water)

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