CGD - Merit Request Inspections

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Details of Merit Request

• Business Unit

• Merit number

• Customer name

• Customer address

• Customer supplied contact details

  Yes

  No

  N/A

• Customer requested feedback

  Yes

  No

  N/A

• Feedback provided to customer

  Yes

  No

  N/A

• Quality of feedback provided

  clear

  unclear

  N/A

• Factual comments no interpretation in the feedback provided.

  Yes

  No

  N/A

• Date Council notified of the hazard / defect

  Date

• Site address

• Request details

Inspection / Completion Details

• Inspected / actioned by

• Inspection / action date and time

  Date

• Was the inspection completed within the recommended timeframes

  Yes

  No

  N/A

• Detail of action taken

  Yes

  No

  N/A

• Date of work completed

  Date

• Was the completion of work or program for work to be completed within the recommend timeframes'

  Yes

  No

  N/A

Assessment details

• Percentage of work completed

• Observations of work completed

• Quality rating on works performed: 0 Not Applicable 1 Excellent, 2 Very Good, 3 Good, 4 Average, 5 Poor'

• Storyboard comments clear and concise

  Yes

  No

  N/A

• Identified additional work required

  Yes

  No

  N/A

• Assessors comments

• Assessment officer signature

  Sign