Information

  • Account Name (enter in CAPS please)

  • Account #

  • SiteID

  • Contact

  • Location
  • Phone Number

  • email Address

  • Conducted On

  • Prepared By

  • Enter your name if not listed

  • Is this still a current Swisher account ?

  • Type of Account?

Dishmachine Process Area

  • Insert a Picture of the Dishmachine and the Area around it

Dishmachine General Info

  • Enter Other make or N/A if there is no dish machine.

  • Enter dishmachine make / name

  • Model

  • Voltage

Dishmachine Chemistry

Dispensers

  • Warewash control system

  • Enter Dispenser make / name

  • Encapsulated / Solid Bowl

  • Enter bowl make / name

Products / Titrations

  • Dishmachine Water Hardness

  • Water Softener system checks

  • Was Repair Completed

  • Dishmachine Detergent

  • Titration / Volume / ml/rack

  • Was an adjustment required?

  • Enter adjusted Titration / Volume / ml/rack

  • Dishmachine Rinse Additive

  • Titration / Volume / ml/rack

  • Was an adjustment required?

  • Enter adjusted Titration / Volume / ml/rack

  • Dishmachine Sanitizer

  • Titration / Volume / ml/rack

  • Was an adjustment required?

  • Enter adjusted Titration / Volume / ml/rack

Dishmachine Inspection

Machine Controls

  • Pre Wash Temperature

  • Was Repair Completed

  • Wash Tank Temperature

  • Was Repair Completed

  • Power Rinse Temperature

  • Was Repair Completed

  • Final Rinse Temperature

  • Was Repair Completed

  • Final Rinse Pressure

  • Was Repair Completed

  • Fresh Water Feedback

  • Was Repair Completed

  • Energy Saver

  • Was Repair Completed

Mechanical Operation

  • Fill Valve

  • Was Repair Completed

  • Cam Timer

  • Was Repair Completed

  • Micro switch

  • Was Repair Completed

  • Wash Arms

  • Was Repair Completed

  • Rinse Arms

  • Was Repair Completed

  • Rinse arm thumb screw

  • Was Repair Completed

  • Final Rinse Jets

  • Was Repair Completed

  • Final Rinse Solenoid

  • Was Repair Completed

  • Overflows

  • Was Repair Completed

  • Drain Valves

  • Was Repair Completed

  • Conveyor Belt / Chain

  • Was Repair Completed

  • Conveyor dog

  • Was Repair Completed

  • Curtains

  • Was Repair Completed

  • Racks

  • Was Repair Completed

Chemical Delivery

  • Foot Valves

  • Was Repair Completed

  • Chemical pick up tubing

  • Was Repair Completed

  • Squeeze tubes

  • Was Repair Completed

  • Encapsulated / Detergent bowl

  • Was Repair Completed

  • Feed tubing to machine

  • Was Repair Completed

  • Detergent injection fittings

  • Was Repair Completed

  • Rinse injection fitting

  • Was Repair Completed

  • Sanitizer injection fitting

  • Was Repair Completed

  • Vacuum breaker

  • Was Repair Completed

  • Water solenoid

  • Was Repair Completed

  • Saddle valve

  • Was Repair Completed

  • Control Board

  • Was Repair Completed

  • Wall Brackets

  • Was Repair Completed

Signage

  • Wall Chart

  • Was Repair Completed

  • Dispenser Product Stickers

  • Was Repair Completed

Operator Procedures

  • Racking

  • Was Training Provided?

  • Prescrapping

  • Was Training Provided?

  • Presoaking

  • Was Training Provided?

  • Deliming

  • Was Training Provided?

  • Curtain Cleaning

  • Was Training Provided?

  • Tank Water Change / Fill

  • Was Training Provided?

  • Scrap Tray Cleaning

  • Was Training Provided?

  • Equipment Cleaning

  • Was Training Provided?

  • Sanitizer Level checked?

  • Was training and or test strips provided?

Dishmachine Current Results

  • Water / Ice Tea Glasses

  • Describe

  • Stemware

  • Describe

  • Plates and Saucers

  • Describe

  • Cups and Bowls

  • Describe

  • Flatware

  • Describe

Presoak Process Area

  • Insert a Picture of the Presoak Area

Presoak General Info

  • Presoak Dispenser Model

  • Enter dispenser make / name

  • Presoak Product

  • oz./gal dispensed

  • Was an adjustment required?

  • Enter the adjusted titration / oz/gal

Presoak Inspection

  • Chemical Pick up tubing

  • Was Repair Completed

  • Feed Tubing

  • Was Repair Completed

  • Foot Valve

  • Was Repair Completed

  • Water Line

  • Was Repair Completed

  • Wall Brackets

  • Was Repair Completed

Signage

  • Dispenser Product Stickers

  • Was Repair Completed

  • Wall Chart

  • Was Repair Completed

Pot & Pan Three Sink Process Area

  • Insert a Picture of the Three Compartment Sink Area

Pot & Pan Three Sink General Info

  • Pot & Pan Dispenser Model

  • Enter Dispenser name / make

  • Pot & Pan Product

  • oz./gal dispensed

  • Was an adjustment required?

  • Enter adjustment titration / oz/gal

  • Third Sink Sanitizer Dispenser

  • Sanitizer Product

  • ppm level

  • Was an adjustment required?

  • Enter adjustment ppm

  • Did operator test sanitizer level?

  • Was Training Provided?

Pot & Pan Inspection

  • Dispenser

  • Was Repair Completed

  • Chemical pick up tubing

  • Was Repair Completed

  • Feed tubing to sinks

  • Was Repair Completed

  • Foot Valves

  • Was Repair Completed

  • Water valve connections

  • Was Repair Completed

  • Saddle valve

  • Was Repair Completed

  • Wall Brackets

  • Was Repair Completed

Signage

  • Wall Chart

  • Was Repair Completed

  • Wash/Rinse/Sanitizer Stickers

  • Was Repair Completed

  • Fill to this Line Stickers

  • Was Repair Completed

  • Dispenser Product Stickers

  • Was Repair Completed

Pot and Pan Current Results

  • Pots and Pans

  • Describe

  • Dishes

  • Describe

  • Food Preparation Surfaces

  • Describe

Kitchen Ancillary Process Area

  • Insert a Picture of the Ancillary Kitchen Area

Kitchen Ancillary General Info

  • Ancillary Dispenser Model

  • Enter dispenser make / name

Glass Cleaner Product

  • Swisher Glass Kleen

  • Tip Color and oz./gal dispensed

  • Swisher Ultra Glass Cleaner

  • Tip Color and oz./gal dispensed

APC Product

  • Swisher Brisa General Purpose Cleaner

  • Tip Color and oz./gal dispensed

  • Swisher Citrus Plus

  • Tip Color and oz./gal dispensed

  • Swisher OCP Hi-Ox

  • Tip Color and oz./gal dispensed

  • Swisher Pine Plus

  • Tip Color and oz./gal dispensed

  • Swisher Ultra Citrus Neutral

  • Tip Color and oz./gal dispensed

Floor Cleaner Product

  • Swisher EZ Floor Cl

  • Tip Color and oz./gal dispensed

  • Swisher Quarry Tile Floor Cleaner

  • Tip Color and oz./gal dispensed

  • Swisher Ultra Quarry Tile Floor Cleaner

  • Tip Color and oz./gal dispensed

  • Swisher Wash N Go

  • Tip Color and oz./gal dispensed

Degreaser Product

  • Swisher Hercules

  • Tip Color and oz./gal dispensed

  • Swisher Neon - Spray Cleaner / Degreaser

  • Tip Color and oz./gal dispensed

  • Swisher Purple Mean Clean

  • Tip Color and oz./gal dispensed

  • Swisher Red - Degreaser

  • Tip Color and oz./gal dispensed

  • Swisher Synplex Steam Clean Compound

  • Tip Color and oz./gal dispensed

  • Swisher Ultra Degreaser

  • Tip Color and oz./gal dispensed

Other Products Installed

  • Swisher Odor-Kleen

  • Tip Color and oz./gal dispensed

  • Swisher Ultra Air Freshener-Fresh Linen

  • Tip Color and oz./gal dispensed

  • Swisher Ultra Air Freshener-Mango

  • Tip Color and oz./gal dispensed

  • Swisher Yellow - Odor Neutralizer

  • Tip Color and oz./gal dispensed

  • Swisher Bathroom Kleen

  • Tip Color and oz./gal dispensed

  • Swisher Tub & Tile Kleen

  • Tip Color and oz./gal dispensed

  • Swisher Ultra Tub & Tile

  • Tip Color and oz./gal dispensed

  • Swisher Lemon Kleen Disinfectant

  • Tip Color and oz./gal dispensed

  • Swisher Nutra Bac

  • Tip Color and oz./gal dispensed

  • Swisher Ultra Disinfectant

  • Tip Color and oz./gal dispensed

  • Swisher Ultra Non-Acid Bathroom Cleaner

  • Tip Color and oz./gal dispensed

Regulatory Compliance

Regulatory Items

  • MSDS on location for all products

  • Discussed with customer

  • Follow Required:

  • MSDS Book/Station

  • Discussed with customer

  • Follow Required:

Opportunities - Programs

Select Swisher programs that can be sold into this account.

  • Warewashing Program

  • Enter estimated weekly revenue dollars $

  • Swisher Total Image

  • Enter estimated weekly revenue dollars $

  • Paper (towel, tissue, seat covers, etc.)

  • Enter estimated weekly revenue dollars $

  • Handcare Program (soap / sanitizer)

  • Enter estimated weekly revenue dollars $

  • Air Freshener

  • Enter estimated weekly revenue dollars $

  • Linen Program

  • Enter estimated weekly revenue dollars $

  • Laundry / Housekeeping

  • Enter estimated weekly revenue dollars $

  • Waste Program

  • Enter estimated weekly revenue dollars $

  • Pest Control (Terminex)

  • Enter estimated weekly revenue dollars $

  • Other items sold

  • Enter estimated weekly revenue dollars $

Opportunities - CBI products

Select CBI products that can be sold into this account.

Floor Cleaners & Misc. Items

  • 502031 - Concrete Cleaner - (heavy duty powder for removing oils and dirt from concrete) - 25#

  • 502065 - Quarry Tile Floor Cleaner (QTFC) - (acid based daily use anti slip quarry tile floor cleaner) - 4/1 gal

  • 502074 - Steady Step - (powdered anti slip floor cleaner equivalent to intuitional tide) - 36#

  • 502090 - Nutra Bac - (neutral disinfectant cleaner. Can also be used as a daily mop or damp mop.) - 2/1 Gal

  • 502100 - Select Neutral APC - (neutral damp mop and all purpose neutral cleaner) - 4/1 gal

  • 506096 - Select Block and Tile Whitener - (mold and mildew remover for tile also cutting board whitener) - 6/32oz

  • 510020 - Cyclone Detergent & Floor Cleaner - (portion pack anti slip quarry tile floor cleaner) - 125/1.5oz

  • 545234 - Shoot Out carpet cleaner - (vanishing action spotter for removing spots on carpet) - 6/18oz

Laundry Products

  • 512039 - LLP - powder lemon detergent - (bulk laundry powder) - 25#

  • 512042 - Tuff Laundry Detergent Powder - (bulk laundry powder) - 40#

Hand Soap

  • 514125 - Luxury Hand Soap-Bulk - (Pure coconut oil hand soap fro rich smooth lather) - 2/1 gal

  • 514131 - Pink Hand Soap-Bulk - (all purpose pink hand soap with high lather) - 4/1 gal

  • 514148 - Coconut Hand Soap with triclosan - (Coconut oil with triclosan) - 2/1 gal

  • 514155 - Bacti Crème Hand Soap-Bulk - (pink lotion hand soap, NOT antibacterial) - 2/1 gal

  • 514420 - Foaming Hand Soap - (cartridge) - 4/1000 ml

  • 514423 - Foaming Antibac Hand Soap - (cartridge) - 4/1000 ml

  • 514620 - Foaming Hand Sanitizer - (cartridge) - 4/1000 ml

Odor Neutralizers

  • 516011 - Snappy Apple - (air freshener) - 6/10 oz

  • 516016 - Tropic Breeze - (air freshener) - 6/10 oz

  • 516021 - Citrus Lemon - (air freshener) - 6/10 oz

  • 516204 - Yellow RTU Odor Neutralizer - (Clean scent odor neutralizing counteractant and deodorizer ) - 6/32oz

  • 516206 - Odor Go - (fabreez type product eliminates odors leave fresh smell) - 12/32oz

  • 516248 - Yellow - Odor Neutralizer - (Clean scent odor neutralizing counteractant and deodorizer ) - 2.5 gal

  • 545409 - Refresh - (urine eradicator, add to mop bucket for fresh bathroom floors) - 12/32oz

Sanitizers

  • 520011 - Foaming Disinfectant Spray - (foaming disinfectant cleaner compares/scrubbing bubbles) - 6/18oz

  • 520021 - Health Care Disinfectant Spray - (Disinfectant spray compares to Lysol) - 6/15.5oz

  • 520040 - Select Lemon Disinfectant Cleaner - (effective lemon scent disinfectant, Quat based) - 4/1 gal

  • 520090 - Steramie Tablets - (Quat Sani-Tabs) - 6/8oz

  • 520109 - Bio-San - (low temp sanitizer) - 4/1 gal

  • 520110 - Bio-San - (low temp sanitizer) - 5 gal

  • 520136 - Sani-Rinse II - (multi use Quat sanitizer dilute to 250 ppm) - 4/1 gal

  • 520137 - Sani-Rinse II - (multi use Quat sanitizer dilute to 250 ppm) - 5 gal

  • 545425 - Clear RTU no rinse sanitizer - (ready to use multi use Quat sanitizer diluted to 250 ppm ) - 6/32oz

All Purpose Cleaners

  • 522011 - All Purpose - (Aerosol all purpose cleaner) - 6/19oz

  • 545215 - Cameo - (Crème Cleanser) - 12/1qt

  • 522055 - Touch Up - (ready to use all purpose cleaner) - 6/32oz

  • 522071 - Freezer Cleaner - (non freezing) - 2/1 gal

  • 522130 - Select Pine Cleaner - (pine scented all purpose cleaner) - 4/1 gal

  • 522131 - Pine Plus - (pine cleaner with pine oil) - 2/1 gal

  • 522134 - Brisa General Purpose Cleaner - (Lavender fragrance general purpose cleaner (fabuloso)) - 4/1 gal

  • 522165 - Hi Ox general purpose cleaner - (oxygen all purpose cleaner) - 4/1 gal

Glass and Hard Surface

  • 524011 - Glass Cleaner Blue aerosol - (all purpose aerosol glass cleaner alcohol based ) - 6/19oz

  • 524014 - Blue RTU Glass Cleaner - (non ammoniated glass cleaner safe on plastics) - 6/32oz

  • 524020 - Select Glass & Hard Surface Cleaner - (Ammoniated hard surface cleaner and light duty degreaser) - 4/1 gal

Bowl Cleaners

  • 526005 - Winter Green Bowl Cleaner - (Premium acid bowl cleaner contains hydrochloric acid ) - 6/32oz

  • 526008 - VisiClean Bowl Cleaner - (Acid bowl cleaner contains hydrochloric acid ) - 12/32oz

  • 526010 - AFB Acid Free Bowl Cleaner - (non acid bowl cleaner RTU with flip up top) - 6/32oz

Kleen and Ultra Products

  • 527001 - Glass Kleen - (super concentrate must go thru dispensers closed loop top) - 4/1 gal

  • 527009 - Sani-Kleen - (ready to use table top cleaner and sanitizer) - 12/32oz

  • 527011 - Ordor-Kleen - (odor counteractant and neutralizer leaves fresh smell) - 4/1 gal

  • 527016 - Tub & Tile Kleen - (acid based fixture cleaner removes hard water stains) - 4/1 gal

  • 527019 - Bathroom Kleen - (non acid all purpose bathroom cleaner works well on oils) - 4/1 gal

  • 527021 - Purple Mean Kleen - (all purpose degreaser and cleaner) - 4/1 gal

  • 527023 - Lemon Disinfectant Kleen - (lemon scented disinfectant/cleaner) - 4/1 gal

  • 527025 - Wash N Go - (no rinse enzyme floor cleaner) - 4/1 gal

  • 527027 - EZ Floor Cl - (no rinse enzyme floor cleaner) - 4/1 gal

  • 527040 - Ultra Glass Cleaner - (super concentrated glass cleaner streak free) - 3-1/2 gal

  • 527043 - Ultra Degreaser - (super concentrated degreaser and gp cleaner) - 3-1/2 gal

  • 527045 - Ultra Disinfectant - (super concentrated disinfectant) - 3-1/2 gal

  • 527049 - Ultra Tub & Tile - (super concentrated acid base bathroom cleaner) - 3-1/2 gal

  • 527052 - Ultra Non-Acid Bathroom Cleaner - (super concentrated non acid bathroom cleaner) - 3-1/2 gal

  • 527055 - Ultra Citrus Neutral - (super concentrated neutral cleaner and damp mop) - 3-1/2 gal

  • 527061 - Ultra Air Freshener-Fresh Linen - (super concentrated air freshener and odor control) - 3-1/2 gal

  • 527063 - Ultra Air Freshener-Mango - (super concentrated air freshener and odor control) - 3-1/2 gal

  • 527066 - Ultra Quarry Tile Floor cleaner - (super concentrated quarry tile floor cleaner) - 3-1/2 gal

Degreasers

  • 528020 - Select HD Degreaser & Floor Cleaner - (heavy duty cleaner and degreaser for all kitchen needs) - 4/1 gal

  • 528050 - Hercules - (heavy duty degreaser and floor cleaner) - 4/1 gal

  • 528051 - Select All Purpose Degreaser - (premium grade all purpose cleaner and degreaser) - 4/1 gal

  • 528060 - Hercules - (heavy duty degreaser and floor cleaner) - 5 gal

  • 528115 - Citrus Plus - (heavy duty degreaser and floor cleaner) - 2/1 gal

  • 528127 - Dumpster Dandy - (connect to garden hose and spray controls odor & insects) - 2/64oz

  • 528128 - Dumpster Dandy - (connect to garden hose and spray controls odor & insects) - 4/32oz

  • 528154 - Neon - Spray Cleaner / Degreaser - (heavy duty degreaser and floor cleaner) - 4/1 gal

  • 528159 - Red - Degreaser - (heavy duty degreaser and floor cleaner) - 4/1 gal

  • 528163 - Neon - Spray Cleaner / Degreaser - (heavy duty degreaser and floor cleaner) - 2.5 gal

Oven Cleaners

  • 530010 - Fryolator Deep Fat Fry Cleaner - (bulk packed deep fryer cleaner and boil out) - 2/7#

  • 530011 - Fryolator Deep Fat Fry Cleaner - (portion packed deep fryer boil out cleaner) - 100/8oz

  • 530020 - Grease-Off Griddle & Hood Cleaner - (heavy duty thick vertical cling type product paint or wipe on) - 2/100oz

  • 530031 - Oven/Grill Foaming Cleaner - (aerosol oven cleaner, effective cleaner on all surfaces) - 6/18oz

  • 530057 - Select Grill /Oven Majic - (dissolves carbon and encrusted grease build up.) - 6/32oz

  • 530059 - Select Grill /Oven Majic - (dissolves carbon and encrusted grease build up.) - 2/1 gal

  • 530061 - Select Oven & Grill Cleaner - (premium liquid oven cleaner works on hot or cold surfaces) - 4/1 gal

  • 530100 - Oven Blaster - Alkaline Oven Cleaner - (premium liquid oven cleaner dissolves build ups quickly) - 3/32oz

  • 530103 - Oven Blaster - Alkaline Oven Cleaner - (premium liquid oven cleaner dissolves build ups quickly) - 4/1 gal

Drain Cleaners and Enzyme Treatments

  • 532015 - Main Drain - drain maintainer / cleaner - (fumeless fast acting drain opener) - 12/32oz

  • 532028 - Bac Man - (enzyme for grease traps & drains, urine & odor eradicator ) - 6/32oz

  • 532029 - Bac Man - (enzyme for grease traps & drains, urine & odor eradicator ) - 4/1 gal

  • 532030 - Bac Man - (enzyme for grease traps & drains, urine & odor eradicator ) - 5 gal

SS Polish

  • 534003 - Brassy - (non abrasive aerosol metal polish citrus scent) - 6/14oz

  • 534040 - WB SSP - Liquid - (water based stainless steel polish) - 6/32oz

  • 534031 - Stainless Steel Polish aerosol - (SS polish comparable to Sheila shine) - 6/16oz

  • 534121 - Lemon Shine furniture polish - (fruity lemon scented furniture polish) - 6/15oz

  • 534125 - Glow Cleaner and Polish - (all purpose polish for wood, plastics, and stainless) - 6/18oz

  • 545224 - SSC metal polish - (oil based cleaner and polish for metal surfaces) - 6/15oz

Pesticides

  • 538021 - Flying and Crawling Insect Spray - (insecticide housekeeping usage not used in food contact area) - 6/15oz

  • 538026 - Wasp & Hornet Spray - (insecticide housekeeping usage not used in food contact area) - 6/16oz

  • 538031 - Ant & Roach killer - (insecticide housekeeping usage not used in food contact area) - 6/18oz

Pot and Pan Detergent

  • 540009 - Sparkle Dish Machine Det - (portion packed for home style dish machines) - 200/1.5oz

  • 540010 - Super B - (solid pink pot and pan detergent) - 4/5#

  • 540020 - Snowey A/P Detergent Beads - (all purpose beaded all purpose powder cleaner) - 50#

  • 540040 - Economy P&P Detergent - (pink pot and pan detergent) - 4/1 gal

  • 540042 - Economy P&P Detergent - (pink pot and pan detergent) - 5 gal

  • 540050 - Lust H/D Pink - (pink lotion pot and Pan detergent high solids) - 4/1 gal

  • 540060 - Lust H/D Pink - (pink lotion pot and Pan detergent high solids) - 5 gal

  • 540100 - Sunshine - (premium high solid dish detergent match to Joy) - 4/1 gal

  • 540101 - Aurora Blue - (premium high solid dish detergent match to Dawn) - 6/28oz

  • 540102 - Aurora Blue - (premium high solid dish detergent match to Dawn) - 4/1 gal

  • 540105 - Sunshine - (premium high solid dish detergent match to Joy) - 5 gal

  • 540107 - Aurora Blue - (premium high solid dish detergent match to Dawn) - 5 gal

  • 540118 - OCP Solid Pot & Pan - (our clean planet pot and pan detergent) - 2/10#

  • 540120 - Power Pot & Pan Detergent - (heavy duty grease cutting pot and pan detergent) - 4/1 gal

  • 540140 - Power Pot & Pan Detergent - (heavy duty grease cutting pot and pan detergent) - 5 gal

  • 540166 - Select HD Lemon Pot & Pan - (lemon scented pot and pan detergent ) - 4/1 gal

  • 540170 - Platinum - (premium high solid dish detergent match to Dawn) - 5 gal

Presoaks & Delimers

  • 542005 - Plasticlean - (Dip it type stain remover safe for all surfaces) - 35/4oz

  • 542006 - Plasticlean - (Dip it type stain remover safe for all surfaces) - 2/8lb

  • 542012 - Silver Soak - (Liquid silver and flatware pre soak) - 4/1 gal

  • 542030 - Silver Brite - (powder silver pre soak with extra detarnishers) - 4/8#

  • 542042 - Striker - (solid flatware pre soak with detarnishers & enzymes) - 2/8#

  • 542050 - DeLime - (lime scale remover) - 4/1 gal

  • 542056 - Select Delimer - (lime scale remover) - 2/1 gal

Warewashing

  • 544005 - Bartender - (low suds bar soap) - 4/1 gal

  • 544025 - Meta Safe - (safe for soft metals, free rinsing works well in soft water) - 4/10#

  • 544031 - Bio-Clean - (low temp detergent) - 5 gal

  • 544040 - Power Clean - (encapsulated high temp detergent with stain removers) - 6/6#

  • 544043 - Extra Strength Plus - (solid dish detergent) - 4/8#

  • 544070 - Multi-Temp Detergent - (low or high temp liquid detergent) - 4/1 gal

  • 544072 - Liquid Metal Safe - (glass machine detergent for soft water applications) - 4/1 gal

  • 544074 - Multi-Temp Detergent - (low or high temp liquid detergent) - 5 gal

  • 544090 - Speed Dry - (hard water premium rinse aid) - 4/1 gal

  • 544100 - Super Rinse - (soft water rinse use with meta safe for spotless results ) - 4/1 gal

  • 544110 - Speed Dry - (hard water premium rinse aid best used with power clean) - 5 gal

  • 544111 - Bio-Rinse - (premium low temp rinse aid) - 5 gal

  • 544114 - Low Temp Rinse - (premium low temp rinse aid) - 5 gal

  • 544112 - Spots Away - (soft water rinse use with meta safe for spotless results ) - 5 gal

Finish

Finish, Comments and Signature

  • Any other items requiring attention or any additional comments?

  • 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.