Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Location
  • Personnel

Customer Information

  • Customer Name

  • Site Location

  • Department

Working hours

  • Departure from home / hotel

  • Arrival on site

  • Departure from site

  • Arrival home / hotel

  • Any expenses(hotel,parking,tolls,congestion charge)

Equipment Information

  • Machine Make and model

  • Machine Serial Number

  • Machine Asset number

  • Photo of outside of machine

Visit Detail

  • Commercial detail

Description of Work to be Done

  • Type of visit

Tick if applicable

  • Check Pipe connections (air, water, steam)

  • Check Door seal

  • Check door safety edge

  • Check Emergency stop button

  • Check steam traps

  • Check Solenoid valves

  • Check Door safety controls

  • Check Electrical connection

  • Check Filters Air and bio

  • Check Pneumatic valves

  • Check Tri-clover seals

  • Check printer and chart recorder

  • Check all strainers

  • Trolleys and carriages

  • Check displays

  • Is machines functioning to customers expectations?

Parts

  • Any parts fitted

  • Are any parts required following your visit?

Visit Summary

  • Summary and any recommendations

  • Any photos to support findings or recommendations

  • Any drawings or sketches to support findings or recommendations

  • Is a return visit required?

  • Is a quotation required for additional items/work?

  • Sychem Engineer

  • Customer Authorised Person

Office Use Only

  • Parts Total

  • Total Travel Time (Hours)

  • Total Labour (Hours)

  • Call Out Fee

  • First Hour Charge

  • Subsequent Hour Charge

  • Over Night Expenses

  • Misc

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.