Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Appendix 7 - Base Building Inspection Checklist (Version 1 Sample)
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Property:
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Date:
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Inspected By:
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Date Last inspected:
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Reviewed By:
Inspection Issue
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General Housekeeping
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Work areas free from rubbish and obstructions
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Surfaces safe and suitable
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Free from slip / trip hazards
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Floor openings covered
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
All mechanical and service rooms are clean 7 tidy, clear of combustibles and free from storage
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
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No combustible dust build-up
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
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Combustible yard storage is appropriately separated from buildings (e.g., pallets > 10m from building)
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
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Thoroughfares & Emergency Exits
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Unobstructed and clearly defined
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Date Completed
-
Corrective Actions Taken
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Adequate lighting
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Vision at corners
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Date Completed
-
Corrective Actions Taken
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Wide enough
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Emergency exit signage
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Exit doors easily opened from inside
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Exit path ways clear of obstruction
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
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Electrical
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No broken plugs, sockets, switches
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
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Corrective Actions Taken
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Date Completed
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No frayed or defective leads
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Office and other electrical appliances equipment in good condition
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
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Equipment and leads inspected and tagged
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
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Date Completed
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No strained leads
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
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Date Completed
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No cable-trip hazards
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
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Date Completed
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Lock-out procedures / danger tags in place
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
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Date Completed
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Earth leakages systems used
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
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Date Completed
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Start / Stop switches clearly identified
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
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Date Completed
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Combustibles are a minimum of 1m from electrical appliances, switchboards and other electrical equipment
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
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Corrective Actions Taken
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Date Completed
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No combustible storage in electrical areas or rooms
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Electrical circuits are not overloaded i.e. excessive use of power boards and double adaptors
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
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Date Completed
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No temporary wiring
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
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Switchrooms clearly identified & locked off
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
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Clear spaces are maintained around battery chargers
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
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Date Completed
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Hazardous Chemicals
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Stored appropriately (including use of flammable liquids cabinets)
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
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Corrective Actions Taken
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Date Completed
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Containers labeled correctly
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Adequate ventilation / exhaust systems
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Protective clothing / equipment available / used
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Safety Data Sheets available
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Chemical handling procedures followed
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Appropriate emergency / first aid equipment
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Hazchem signage displayed
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Areas are clean of spills and residue
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Areas are clear of ignition sources and all equipment is approved for intended use
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
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Date Completed
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Bunded areas are clear of debris and intact
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
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Stairs, Steps and landings
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No worn or broken steps
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Handrails in good repair
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Clear of obstructions
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Adequate lighting
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Emergency lighting
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
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Non-slip treatments / treads in good condition
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
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Date Completed
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Amenities
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Washrooms clean
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
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Corrective Actions Taken
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Date Completed
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Toilets clean
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
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Date Completed
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Lockers clean
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
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Rubbish bins available - Covered
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
First Aid
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Cabinets and contents clean and orderly
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Stock meet requirements
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
First aiders names displayed
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
First aiders location and phone numbers displayed
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Qualified first aider (s)
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Record of treatment and of supplies dispensed
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Fire Control
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Extinguishers, hose reels and hydrants in place
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Fire fighting equipment serviced / tagged
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Appropriate signposting of extinguishers, hose reels and hydrants
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Extinguishers appropriate to hazard
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Protective caps on fire hydrants and booster connections
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Fire doors free from damage and are closed correctly
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Lightweight construction for a fire safety purpose free from damage (e.g., vermiculite coatings on exhausts, fire rated plasterboard)
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
No open fire penetrations in fire compartments (e.g., floors, walls, ceilings, service risers, etc.)
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Alarm / communication system – adequate
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Smoking / naked flame restrictions identified, communicated and observed
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Adequate ash receptacles in smoking areas
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Emergency personnel identified and trained
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Emergency procedures documented – issued
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Emergency telephone numbers displayed
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions TakenCorrective Actions Taken
-
Date Completed
-
All fire protection (manual and automatic) maintained to AS
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
All fire protection (manual and automatic) operational
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Test logs and fire safety statements for all fire protection (manual and automatic) completed, up to date, retained and posted where required
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
No outstanding defects on fire maintenance
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Trial evacuation conducted and minuted
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Personnel trained in use of fire fighting equipment and minuted
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Sprinkler hands are unobstructed (i.e. a minimum of 500mm clearance. Sprinkler heads are also free of paint and vermin nests
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Sprinkler heads are unobstructed a minimum of 1 metre for piled storage
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Fire water supply valves are accessible and locked open
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Fire pumps
are: -
Operational
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Set to start automatically
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Have at least 75% fuel supply
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Accessible and clear of combustibles
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Have adequate water supply
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Hot Work
-
Formal hot work procedure in place
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Tenants, employees and contractors aware of and following procedure
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Hot work permit includes segregation of combustibles, availability of fire fighting appliances and formal fire watch requirements
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Permanent hot work areas have appropriate safety features
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Mobile Plant and Equipment
-
Plant and equipment in good condition
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Daily safety inspection procedures / checklists
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Fault reporting / rectification system used
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Operator trained and licensed
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Warning and instruction displayed
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Warning lights operational
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Reversing alarm operation
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Satisfactory operating practise
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Fire extinguisher provided
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Tyres satisfactory
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
SWL of lifting or carrying equipment displayed
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Machinery and Workbenches
-
Adequate work space
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Clean and tidy
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Free from excess oil and grease
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Adequately guarded
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Date Completed
-
Corrective Actions Taken
-
Warnings or instructions displayed
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Emergency stops appropriately placed and clearly identifiable
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Operated safely and correctly
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Tools in proper place
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Personal Protection
-
Employees provided with PPE
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
PPE being worn by employees
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Sun-cream and sunglasses provided
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Correct signage at access points
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Building Maintenance
-
Roof coverings in good condition
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
No evidence of water leaks
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Date Completed
-
Corrective Actions Taken
-
Roof drains are clear
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Buildings generally in good condition
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Kitchen Exhaust system maintenance (If Applicable)
-
Check grease-arresting filers for excessive grease accumulation
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Check hood and its exhaust plenum for excessive grease accumulation
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Check grease gutters for excessive grease accumulation
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Check that grease-arresting filters are secured in the correct position and undamaged
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Clean grease-arresting filters as required
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Clean hood and its exhaust plenum at least annually
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Date Completed
-
Check for excessive leaks or damage to greasearresting filters at least annually, and replace as necessary. NOTE: Non-metallic grease filters and other special types have to be replaced at specific time intervals whether damaged or not. In these cases, follow manufacturer’s instructions
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Corrective Actions Taken
-
Corrective Actions Taken
-
Date Completed
-
Check duct for accumulated grease and clean at least annually
- Poor 0
- Poor 1
- Poor 2
- Excellent 3
- Excellent 4
- Excellent 5
-
Date Completed
-
Full Name & Signature
-
Full Name & Signature
