Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location
  • Unit No:

  • NPU Gauge Reading

DIRTY COMPARTMENT

  • Extractor Unit: NPU

  • Pre Filter

  • Interior Structural and Painted Surfaces

  • Non – Return Vent Grill

  • Door – Exterior Including Sign DIRTY

  • Door Lock

  • Door Closing Mechanism

  • Heating

  • Seating & Clothing Hooks

  • Electrical Sockets

SHOWER COMPARTMENT

  • Interior Structure and Painted Surfaces

  • Shower Cubicles

  • Shower Heads, Hoses, Plumbing

  • Ventilator Grill

  • Connecting Doors Self Closing

  • Drains

CLEAN COMPARTMENT

  • Interior Structure and Painted Surfaces

  • Ventilator Grill

  • Personal Lockers

  • Door – Exterior Including Signs CLEAN

  • Door Closing Mechanism

  • Door Lock

  • Mirror

  • Seating & Clothing Hooks

  • Batter Charging Points

  • Heating

  • Electrical Sockets

EXTERIOR

  • Structure and Painted Surfaces

  • Drains, Pipe work, Water Inlet

  • Waste Water Filter System

  • Support Legs

  • Wheels and Tyres

  • Spare Wheel

  • Towing Connections

  • Electrical Connections

  • Electrical Supply Isolator

  • Earth Leakage

  • Wheel Brace

  • Generator (if applicable)

  • Water Boiler and Flue

  • Gas Bottle and Feeder pipe

  • Hand Brake System

TEST CERTIFICATES

  • Air Clearance

  • DOP

  • Gas

  • Electrical

Any Faults Must Be Reported Immediately to the Asbestos Manager

  • Supervisor Singnature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.