Information

  • Client Name:

  • Address:
  • Inspection Date:

  • Previous Inspection Date:-

  • Inspector:-

PICK UP

  • Waste Bins

  • What is the observation?

  • Please photograph the observation

  • What are the areas of non conformance?

  • Please photograph the none conformance

DUST WIPE

  • Furniture

  • What is the observation

  • Please photograph the observation

  • What are the areas of non conformance?

  • Please photograph the non conformance

  • Ledge/Sills

  • What is the observation

  • Please photograph the observation

  • What are the areas of non conformance?

  • Please photograph the non conformance

  • Glazing

  • What is the observation?

  • Please photograph the observation

  • What are the areas of non conformance?

  • Please photograph the non conformance

  • High Level

  • What is the obervation

  • Please photograph the observation

  • What are the areas of non conformance?

  • Please photograph the non conformance

FLOOR

  • Carpet

  • What is the observation?

  • Please photograph the observation

  • What are the areas of non conformance?

  • Please photograph the non conformance

  • Hard Floor

  • What is the observation?

  • Please photograph the observation

  • What are the areas of non conformance?

  • Please photograph the non conformance

  • Stairs/Lift

  • What is the observation?

  • Please photograph the observation

  • What are the areas of non conformance?

  • Please photograph the non conformance

TOILETS

  • Sinks

  • What is the observation?

  • Please photograph the observation

  • What are the areas of non conformance?

  • Please photograph the non conformance

  • Urinals/W.C.s

  • What is the observation?

  • Please photograph the observation

  • What are the areas of non conformance?

  • Please photograph the non conformance

  • Fittings

  • What is the observation?

  • Please photograph the observation

  • What are the areas of non conformance?

  • Please photograph the non conformance

  • Floor

  • What is the observation?

  • Please photograph the observation

  • What are the areas of non conformance?

  • Please photograph the non conformance

PAPERWORK

  • Specification

  • What is the observation?

  • What are the areas of non conformance?

  • Work Instruction

  • What is the observation?

  • What are the areas of non conformance?

  • Training Sheet

  • What is the observation?

  • What are the areas of non conformance?

  • Dilution Rates

  • What is the observation?

  • What are the areas of non conformance?

  • Period Task Record

  • What is the observation?

  • What are the areas of non conformance?

CONCULSION

  • Summary:

  • Additional Cleaning Requirements:

  • Action to be taken:

  • Supervisors Signature:

  • Date:

  • Managers Signature:

  • Date:

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.