Information
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Conducted on
Monthly Fire Safety Checks
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Date & Time Completed
Fire Safety Checks
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What to check on the Fire Exits, Fire Doors & Fire Extinguishers
Plant Room
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Pool Plant Room - CO2 (Extinguisher)
Reception
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Front Entrance - Foam (Extinguisher)
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Front Entrance - CO2 (Extinguisher)
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(FD1) Management Office (Internal Fire Door)<br>Self Closer & Smoke Seal
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(FD2) Staff Room (Internal Fire Door)<br>Self Closer & Smoke Seal
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(FD3) Ladies 1st Entrance (Internal Fire Door)<br>Self Closer, Glazing & Smoke Seal
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(FD5) Men's 1st Entrance (Internal Fire Door)<br>Self Closer, Glazing & Smoke Seal
Ruby Slippers
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(FE3) Ruby Slippers - Top (Fire Exit Door)
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Ruby Slippers - Water (Extinguisher)
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Ruby Slippers - CO2 (Extinguisher)
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(FE4) Ruby Slippers - Bottom (Fire Exit Door)
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Ruby Slippers Cupboard - Foam (Extinguisher)
3rd Floor & Outer Roof
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Roof - Water (Extinguisher)
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Upper Roof - Water (Extinguisher)
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Upper Roof - Water (Extinguisher)
Staff Room
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Staff Room - CO2 (Extinguisher)
Male Changing Rooms
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(FD6) Men's 2nd Entrance (Internal Fire Door)<br>Self Closer & Smoke Seal
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Male Changing Rooms - Water (Extinguisher)
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(FE1) Male Changing Rooms (Fire Exit Door)
Poolside
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Poolside - CO2 (Extinguisher)
Female Changing Rooms
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(FD4) Ladies 2nd Entrance (Internal Fire Door)<br>Self Closer & Smoke Seal
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Female Changing Rooms - Water (Extinguisher)
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(FE2) Female Changing Rooms (Fire Exit Door)
Gym
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(FD7) Gym Level - Functional Side (Internal Fire Door)<br>Self Closer, Glazing & Smoke Seal
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Gym Floor Functional Side - CO2 (Extinguisher)
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Gym Floor Functional Side - Water (Extinguisher)
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(FD9) Music Room Cupboard (Internal Fire Door)
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Upper Plant Room - Powder (Extinguisher)
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(FD10) Consultation Room (Internal Fire Door)<br>Self Closer
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Gym Floor Studio Side - CO2 (Extinguisher)
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Gym Floor Studio Side - Water (Extinguisher)
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(FD8) Gym Level - Studio Side (Internal Fire Door)<br>Self Closer, Glazing & Smoke Seal
Functional Room Inc Stairwell
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(FE6) Functional Area Stairwell (Fire Exit Door)
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(FD11) Functional Room - Upper Level (Internal Fire Door)<br>Self Closer & Glazing
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Functional Training Room - Water (Extinguisher)
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Functional Training Room - CO2 (Extinguisher)
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(FD13) Functional Room Leading To Studio (Internal Fire Door)<br>Self Closer & Glazing
Studio
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Studio - CO2 (Extinguisher)
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Studio - Water (Extinguisher)
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(FD12) Studio Upper Level (Internal Fire Door)<br>Self Closer
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(FE5) Studio Stairwell (Fire Exit Door)
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Any Action Point / Further Comments / Information
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Write Name & Signature Of Person Completing Check
Monthly Evac+Chair Check
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Date & Time Completed
Evac+Chair Safety Check
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Chair is located in correct location
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Signage to the designated place of relative safety is in place
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Signage is located above the evac chair
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Ensure that the straps and buckles are not damaged
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Check the belts are intact and no signs of damage
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Check all 4 wheels and the brakes on the smaller 2 wheels
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Check there is no sign of damage to the fabric of the seating area
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Any Action Point / Further Comments / Information
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Write Name & Signature Of Person Completing Check
Monthly First Aid Stock Check
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Date & Time Completed
First Aid Stock Check
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Ensure All Expiry Dates Are Checked
First Aid Box Stock
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Accident Forms & Head Injury Forms Are Saved Onto The System
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HSE Sterile Dressings (Large 18cm) (Min 3)
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Order Is Required
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HSE Sterile Dressings (Medium 12cm) (Min 3)
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Order Is Required
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Sterile Triangular Bandages (Min 2)
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Order Is Required
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Eye Pads (Min 2)
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Order Is Required
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Medi Wipes (Box) (Min Packs 1)
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Order Is Required
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Face Shields (Min 2)
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Order Is Required
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Fabric Strapping (Individual Rolls) (Min 3)
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Order Is Required
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Eye Wash (Individual Sachets) (Min 5)
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Order Is Required
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Selection Of Plasters (1 Box)
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Order Is Required
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Heat Retaining Blankets (Min 2)
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Order Is Required
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Gloves (Box) (Min 1 Box)
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Order Is Required
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Ice Packs (Min 1 Box)
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Order Is Required
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First Aid Box Seals (Pack) (Min 1 Pack)
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Order Is Required
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Face Mask (Min 1)
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Order Is Required
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Spare AED Pads - Check & Record Expiry Dates (Min 1)
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Order Is Required
Burns Kit Stock
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Burnshield Hydrogel (Min 1)
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Order Is Required
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Burnshield Burn Blott (Min 2)
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Order Is Required
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Blue Detectable Waterproof Tape (Min 1)
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Order Is Required
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Tuff Kutt Scissors (Min 1)
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Order Is Required
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Limb Dressings (Min 2)
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Order Is Required
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Conforming Bandages (Min 1)
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Order Is Required
Bio-Hazard Kit Stock
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Bio Hazard Bags (Pk 25) (Min 1 Pack)
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Order Is Required
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Absorbent Granules (Min 1 Tube)
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Order Is Required
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One Use Body Fluid Kit (Min 2)
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Order Is Required
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Response Sharps Refill Kit (Min 2 Packs)
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Order Is Required
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Disinfectant Spray (Min 2)
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Order Is Required
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Write Name & Signature Of Person Completing Check
Monthly PPE Check
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Date & Time Completed
General Manager - Lewis Freeman
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Facemask Record Cartridge Expiry Date and confirm type (ABEK P3)<br>Is it clean and free from chemical residues?<br>Is it in good condition and free from cracks, splits?<br>Are they head strap and clips in good condition?
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Gloves<br>Are they clean and free from chemical residues?<br>Are they in good condition, free from holes or tears?<br>Are they stored in an individual plastic bag?
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Wellington Boots <br>Are They Present, Clean & Serviceable?
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Overall's<br>Are they clean and free from chemical residues?<br>Are they free from rips and tears?
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Apron<br>Are they clean and free from chemical residues?<br>Are they free from rips and tears?
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Safety Goggles / Face Shield<br>Are they stored in an individual plastic bag?<br>Are they clean and free from chemical residues?
Deputy General Manager - Chris Corcoran
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Facemask Record Cartridge Expiry Date and confirm type (ABEK P3)<br>Is it clean and free from chemical residues?<br>Is it in good condition and free from cracks, splits?<br>Are they head strap and clips in good condition?
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Gloves<br>Are they clean and free from chemical residues?<br>Are they in good condition, free from holes or tears?<br>Are they stored in an individual plastic bag?
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Wellington Boots <br>Are They Present, Clean & Serviceable?
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Overall's<br>Are they clean and free from chemical residues?<br>Are they free from rips and tears?
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Apron<br>Are they clean and free from chemical residues?<br>Are they free from rips and tears?
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Safety Goggles / Face Shield<br>Are they stored in an individual plastic bag?<br>Are they clean and free from chemical residues?
Deputy General Manager - Dan Flippance
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Facemask Record Cartridge Expiry Date and confirm type (ABEK P3)<br>Is it clean and free from chemical residues?<br>Is it in good condition and free from cracks, splits?<br>Are they head strap and clips in good condition?
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Gloves<br>Are they clean and free from chemical residues?<br>Are they in good condition, free from holes or tears?<br>Are they stored in an individual plastic bag?
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Wellington Boots <br>Are They Present, Clean & Serviceable?
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Overall's<br>Are they clean and free from chemical residues?<br>Are they free from rips and tears?
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Apron<br>Are they clean and free from chemical residues?<br>Are they free from rips and tears?
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Safety Goggles / Face Shield<br>Are they stored in an individual plastic bag?<br>Are they clean and free from chemical residues?
Deputy General Manager - Adele Reed
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Facemask Record Cartridge Expiry Date and confirm type (ABEK P3)<br>Is it clean and free from chemical residues?<br>Is it in good condition and free from cracks, splits?<br>Are they head strap and clips in good condition?
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Gloves<br>Are they clean and free from chemical residues?<br>Are they in good condition, free from holes or tears?<br>Are they stored in an individual plastic bag?
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Wellington Boots <br>Are They Present, Clean & Serviceable?
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Overall's<br>Are they clean and free from chemical residues?<br>Are they free from rips and tears?
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Apron<br>Are they clean and free from chemical residues?<br>Are they free from rips and tears?
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Safety Goggles / Face Shield<br>Are they stored in an individual plastic bag?<br>Are they clean and free from chemical residues?
Deputy General Manager - Milena Eblowska
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Facemask Record Cartridge Expiry Date and confirm type (ABEK P3)<br>Is it clean and free from chemical residues?<br>Is it in good condition and free from cracks, splits?<br>Are they head strap and clips in good condition?
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Gloves<br>Are they clean and free from chemical residues?<br>Are they in good condition, free from holes or tears?<br>Are they stored in an individual plastic bag?
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Wellington Boots <br>Are They Present, Clean & Serviceable?
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Overall's<br>Are they clean and free from chemical residues?<br>Are they free from rips and tears?
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Apron<br>Are they clean and free from chemical residues?<br>Are they free from rips and tears?
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Safety Goggles / Face Shield<br>Are they stored in an individual plastic bag?<br>Are they clean and free from chemical residues?
Senior Membership Advisor - Dan Worth
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Facemask Record Cartridge Expiry Date and confirm type (ABEK P3)<br>Is it clean and free from chemical residues?<br>Is it in good condition and free from cracks, splits?<br>Are they head strap and clips in good condition?
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Gloves<br>Are they clean and free from chemical residues?<br>Are they in good condition, free from holes or tears?<br>Are they stored in an individual plastic bag?
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Wellington Boots <br>Are They Present, Clean & Serviceable?
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Overall's<br>Are they clean and free from chemical residues?<br>Are they free from rips and tears?
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Apron<br>Are they clean and free from chemical residues?<br>Are they free from rips and tears?
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Safety Goggles / Face Shield<br>Are they stored in an individual plastic bag?<br>Are they clean and free from chemical residues?
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Write Name & Signature Of Person Completing Check
Monthly Pool Inspection
Pool
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Check Completed By:-
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Observations
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Attach Any Photos Here
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If Any Defects Identified, Inform The Duty Manager / Operations Manager
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Write Name & Signature Of Person Completing Check
Monthly Work Equipment
Henry Hoover (Cleaning Cupboard)
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Are the casing and cables in good condition?
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Is the item clean? (check filters and blockages)
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Check operation
Handheld Hoover (Gym Office)
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Are the casing and cables in good condition?
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Is the item clean? (check filters and blockages)
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Check operation
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Does the unit charge when plugged into the base?
Steam Cleaner (Cleaning Cupboard)
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Check all cables and wires for damage
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Check frame for cracks and broken parts
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Check handle is secure and not worn
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Check the machine runs and in good working order
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Check lance / hose not worn or damaged
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Check machine is clean
Powerhose (Cleaning Cupboard)
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Check all cables and wires for damage
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Check frame for cracks and broken parts
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Check handle is secure and not worn
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Check the machine runs and in good working order
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Check lance / hose not worn or damaged
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Check machine is clean
Machine Scrubber (Cleaning Cupboard)
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Check all cables and wires on the battery charger for damage
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Check frame for cracks and broken parts
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Check scrubbing brush is not too worn
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Check the machine runs and in good working order
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Check lance / hose not worn or damaged
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Check machine is clean (Inside & Outside)
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Write Name & Signature Of Person Completing Check
