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["                             卫生状况自查表 \n                                                         地点：_________栋"]
[]
["一、室内容器"]
["1、花盆、花瓶、插水生植物\n容器（如万年青、富贵竹等）","有£无£","3天换水一次，并清洗瓶子和须根","是£否£"]
["2、花盆或盆栽底","有£无£","盆底积水清理","是£否£"]
["3、贮水容器\n（水盆、水桶、罐子）","有£无£","洗刷干净\n不用时，是否倒置","是£否£"]
["4、洗手间内易积水容器","有£无£","洗刷干净\n不用时，是否倒置","是£否£"]
["5、饮水机底盘、泡茶用水盘","有£无£","清理积水及3天清洗一次","是£否£"]
["6、水壶、水杯","有£无£","加盖密封","是£否£"]
["三、楼内公共区域"]
["1、露台、过道是否有空瓶、水罐、水缸","有£无£","清理、倒置、保持干燥并摆放整齐","是£否£"]
["2、露台、过道、卫生间等区域是否有积水情况","有£无£","定期清扫","是£否£"]
["3、楼层有无外露的水管、排\n水沟、水渠","有£无£","清理积水或堵塞","是£否£"]
["4、有无公共绿植、水生植物","有£无£","装在特定容器内，定期更换容器内的水","是£否£"]
["5、开水房、饮水机底盘","有£无£","清理积水及3天清洗一次","是£否£"]
["6、楼内施工项目","有£无£","施工物料堆放整齐","是£否£"]
[null,"有£无£","及时清理施工垃圾","是£否£"]
["三、楼外及周边环境"]
["1、楼四周、绿化带有/无空瓶、水罐、水缸","有£无£","清理、倒置、保持干燥并摆放整齐","是£否£"]
["2、楼周有/无外露的水管、排水沟、水渠","有£无£","清理积水或堵塞","是£否£"]
["4、楼内施工项目","有£无£","施工物料堆放整齐","是£否£"]
[null,"有£无£","及时清理施工垃圾","是£否£"]
["检查人员签名："]

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