Title Page

  • Engineer Name/ number

  • Ses store site name/ number

  • WO No/ Task ID

  • Conducted on

  • If any faults/damage is found please provide the following information, asset/make/model/serial number and photos.

Engineer Check List

  • Has engineer signed in / out?

  • Is the engineer wearing the correct PPE?

  • Is all refrigeration equipment asset tegged

Hazards or unsafe conditions

  • Is the site free from hazards and unsafe conditions? If NO, if possible please add photos of the hazard or unsafe condition

Space - R11 Ice Machine

  • Has the ice machine been cleaned & de-scaled? (Please provide photos before & after)

  • Has the condenser been cleaned and is clear?

  • Are all drain pipes clean, clear amd flowing freely?

  • Has HB-30 been run through the system (* every 12 months)

  • Has the cartridge and/or the scalestick been changed?

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.