Daily Chute Room Audit

• Conducted on

  Date

• Audit completed by:

East Chute:

• Assigned To:

• All Personal Protective Equipment (PPE) is present, clean and functioning properly?

  Yes

  No

  N/A

• Entrance Door Closed?

  Yes

  No

  N/A

• Room Kept Cleaned?

  Yes

  No

  N/A

• Safety Chain in place?

  Yes

  No

  N/A

• Additional Comments:

Peters Chute:

• Assigned To:

• All Personal Protective Equipment (PPE) is present, clean and functioning properly?

  Yes

  No

  N/A

• Entrance Door Closed?

  Yes

  No

  N/A

• Room Kept Cleaned?

  Yes

  No

  N/A

• Additional Comments:

West Chute:

• Assigned To:

• All Personal Protective Equipment (PPE) is present, clean and functioning properly?

  Yes

  No

  N/A

• Entrance Door Closed?

  Yes

  No

  N/A

• Room Kept Cleaned?

  Yes

  No

  N/A

• Additional Comments:

Queeny Chute:

• Assigned To:

• All Personal Protective Equipment (PPE) is present, clean and functioning properly?

  Yes

  No

  N/A

• Entrance Door Closed?

  Yes

  No

  N/A

• Room Kept Cleaned?

  Yes

  No

  N/A

• Additional Comments:

• Auditors Signature:

  Sign