Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Equipment/Item details

  • Select date

  • Equipment type

  • Photo reference

  • Serial number

  • Model number

  • Assigned unique I.D?

  • Dimensions

Current state

  • Estimated or known age in years

  • Tested in operation?

  • Has it been P.A.T tested if necessary?

  • Record previous P.A.T tag here

  • Is the appliance in good order and safe?

  • Defects

  • Is the area it is situated in safe/suitable?

  • Defects

  • Are all other associated parts in good order allowing proper function, i.e drainage, power supply, ventilation, waste etc.

  • Defects

Replacement and servicing

  • If known give estimated cost here.

  • Will the replacement require any additional works?

  • Who is covering the replacement cost?

Planned preventative maintenance schedule

  • If ongoing maintenance and servicing is necessary, who is covering the cost?

  • Testing interval in months

  • Is there someone currently providing certification?

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.