Eco FM_CA_001

• Client Name:

• Address:
  Address

• Inspection Date:

  Date

• Previous Inspection Date:-

  Date

• Inspector:-

PICK UP

• Waste Bins

  PASS

  OBSERVATION

  FAIL

  N/A

• What is the observation?

• Please photograph the observation

  Media

• What are the areas of non conformance?

• Please photograph the none conformance

  Media

DUST WIPE

• Furniture

  PASS

  OBSERVATION

  FAIL

  N/A

• What is the observation

• Please photograph the observation

  Media

• What are the areas of non conformance?

• Please photograph the non conformance

  Media

• Ledge/Sills

  PASS

  OBSERVATION

  FAIL

  N/A

• What is the observation

• Please photograph the observation

  Media

• What are the areas of non conformance?

• Please photograph the non conformance

  Media

• Glazing

  PASS

  OBSERVATION

  FAIL

  N/A

• What is the observation?

• Please photograph the observation

  Media

• What are the areas of non conformance?

• Please photograph the non conformance

  Media

• High Level

  PASS

  OBSERVATION

  FAIL

  N/A

• What is the obervation

• Please photograph the observation

  Media

• What are the areas of non conformance?

• Please photograph the non conformance

  Media

FLOOR

• Carpet

  PASS

  OBSERVATION

  FAIL

  N/A

• What is the observation?

• Please photograph the observation

  Media

• What are the areas of non conformance?

• Please photograph the non conformance

  Media

• Hard Floor

  PASS

  OBSERVATION

  FAIL

  N/A

• What is the observation?

• Please photograph the observation

  Media

• What are the areas of non conformance?

• Please photograph the non conformance

  Media

• Stairs/Lift

  PASS

  OBSERVATION

  FAIL

  N/A

• What is the observation?

• Please photograph the observation

  Media

• Yes

  No

  N/A

• What are the areas of non conformance?

• Please photograph the non conformance

  Media

TOILETS

• Sinks

  PASS

  OBSERVATION

  FAIL

  N/A

• What is the observation?

• Please photograph the observation

  Media

• What are the areas of non conformance?

• Please photograph the non conformance

  Media

• Urinals/W.C.s

  PASS

  OBSERVATION

  FAIL

  N/A

• What is the observation?

• Please photograph the observation

  Media

• What are the areas of non conformance?

• Please photograph the non conformance

  Media

• Fittings

  PASS

  OBSERVATION

  FAIL

  N/A

• What is the observation?

• Please photograph the observation

  Media

• What are the areas of non conformance?

• Please photograph the non conformance

  Media

• Floor

  PASS

  OBSERVATION

  FAIL

  N/A

• What is the observation?

• Please photograph the observation

  Media

• What are the areas of non conformance?

• Please photograph the non conformance

  Media

PAPERWORK

• Specification

  PASS

  OBSERVATION

  FAIL

  N/A

• What is the observation?

• What are the areas of non conformance?

• Work Instruction

  PASS

  OBSERVATION

  FAIL

  N/A

• What is the observation?

• What are the areas of non conformance?

• Training Sheet

  PASS

  OBSERVATION

  FAIL

  N/A

• What is the observation?

• What are the areas of non conformance?

• Dilution Rates

  PASS

  OBSERVATION

  FAIL

  N/A

• What is the observation?

• What are the areas of non conformance?

• Period Task Record

  PASS

  OBSERVATION

  FAIL

  N/A

• What is the observation?

• What are the areas of non conformance?

CONCULSION

• Summary:

• Additional Cleaning Requirements:

• Action to be taken:

• Supervisors Signature:

  Sign

• Date:

  Date

• Managers Signature:

  Sign

• Date:

  Date