Title Page

  • Conducted on

  • Conducted By

  • Site name

  • Integral job number

Health & Safety Questions

  • Has the relevant risk assessment been carried out?

  • Does the work involve working at height?

  • Have you made the store aware and completed the relevant store processes?

  • Detail any other Health & Safety issues

Costco Packs

    Please complete one section per pack
  • Detail the pack identification e.g. HT1

  • Detail the refrigerant used in this pack

  • Is the refrigerant level visible in the sigh glass?

  • Is the pack oil level satisfactory?

  • Are there any alarms on the main controller or backup controller relating to this pack?

  • Are all compressors operational and free of undue vibration

  • Are all compressor crank case heaters operation?

  • Do the compressor oil regulators have a good oil level and are they operational?

  • Is the pack free from oil?<br>

  • Is there any evidence of floodback?

  • Are there any electrical burn marks within electrical panel?

  • Is the isolator in good condition and fully functional?

  • Does the pack have a main HP switch fitted?

  • Speak to the office to check if HP Switch has been tested within the last 12 months

  • Detail the main pack controller HP safety settings

  • Are all extract fans operational and lights working?

  • Are all condenser / gas cooler fans operation?

  • Are the condensers clear of debris after standard brush down?

  • Generate an alarm and ensure a signal is raised on the panel. Has the signal been received?

  • Confirm the pack is tidy and clear of rubbish

  • Oil filter checks - Select relevant statement

  • Drier filter checks - Select relevant statement

  • Confirm leak testing has been completed on accessible areas

  • Has a leak been detected?

Costco Coldrooms

    Please complete one section per coldroom
  • Detail the coldroom type

  • Are all evaporators clear of ice/debris

  • Are all evaporator fans working?

  • Are all drains clear?

  • Are probes/thermosimples in the correct position and working?

  • Is the coldroom control panel in good order with no burnt cable connections?

  • Are there any coldroom fabrication issues?

  • Confirm leak testing has been completed on accessible areas

  • Has a leak been detected?

Costco shopfloor

Shop Floor Checks

  • Confirm leak testing has been done on accessible areas

  • Have any leaks been identified

  • Are all thermosimple displays working?

  • Are all case lights working?

  • Is there a good airflow on the caes?

  • Are kickplates fitting as they should be?

  • Are there any visible water leaks?

  • Are all cases in good condition?

Costco Leak Detection & Alarm panel

  • Are there any current alarms on the alarm panel?

  • Are there any recent repeat alarms in the alarm panel history?

  • Complete a dial out test to ensure alarm is received by monitoring company and detail the time this was carried out

  • Confirm the dial out test worked successfully

  • Is there a leak detection panel on this site?

  • Detail the manufacturer

  • Are there any alarms on the leak detection panel?

Costco general site checks

  • Are there any empty cylinders on site?

  • Detail any other comments

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.