CLP 2e. Weekly PPM Checks - DO NOT USE

• Conducted on

  Date

• Completed By

• Date Completed

  Date

Electric Power Hose

• Is this equipment in use?

  Yes

  No

• Check all cables and wires for damage

  Safe

  At Risk

• Check frame for cracks and broken parts

  Safe

  At Risk

• Check handle is secure and not worn

  Safe

  At Risk

• Check machine runs and in good working order

  Safe

  At Risk

• Check lane / hose not worn or damaged

  Safe

  At Risk

• Check machine is clean

  Safe

  At Risk

Finger Guards On Toilet Doors (Entry & Internal Door)

• Check Fingers Guards Are Secure To The Doors & Cover All Areas From Trapping Fingers

  Safe

  At Risk

• Take picture of fault and give brief description

  Media

• Signature

  Sign