Title Page

  • Site conducted

  • Site name

  • Conducted on

  • Prepared by

  • Location

  • Scheme Type

Legionella (Weekly)

  • Weekly Flush Required and carried out at this visit

Fire Panel / System

Fire Panel (Weekly Check)

  • Is a Fire Panel Check required?

  • Complete Fire Panel Weekly Check section

  • Is the Fire Panel working correctly?

  • Did you carry out a functional test of the Fire Alarm? If NO state why in notes section of question.

  • If functional test carried out did the Fire Alarm operate correctly and as expected?

  • Provide details of fault

  • Reported on FRA Maintenance Works and Customer Services as urgent if alarm is not fully functioning.

General Safety - Immediate Area Only

  • Is the area free from hazards?

  • Record as hazard in section below and provide risk rating, report required action to Customer Services as necessary

  • Compliance - IDENTIFIED RISKS and/or HAZARDS
  • Have risks and/or hazards been identified?

  • What is the risk rating?

  • Add the required action or action taken using the ACTION box. You must give the action the same priority rating. Add photos as required.

Signature

  • Add signature

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.