Information
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Client Name:
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Address:
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Inspection Date:
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Previous Inspection Date:-
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Inspector:-
PICK UP
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Waste Bins
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Please photograph:
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What is the observation?
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Please photograph the observation
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What are the areas of non conformance?
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Please photograph the none conformance
DUST WIPE
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Furniture
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Please photograph:
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What is the observation
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Please photograph the observation
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What are the areas of non conformance?
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Please photograph the non conformance
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Ledge/Sills
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Please photograph:
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What is the observation
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Please photograph the observation
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What are the areas of non conformance?
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Please photograph the non conformance
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Glazing
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Please photograph:
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What is the observation?
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Please photograph the observation
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What are the areas of non conformance?
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Please photograph the non conformance
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High Level
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Please photograph:
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What is the obervation
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Please photograph the observation
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What are the areas of non conformance?
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Please photograph the non conformance
FLOOR
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Carpet
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Please photograph:
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What is the observation?
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Please photograph the observation
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What are the areas of non conformance?
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Please photograph the non conformance
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Hard Floor
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Please photograph:
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What is the observation?
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Please photograph the observation
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What are the areas of non conformance?
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Please photograph the non conformance
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Stairs/Lift
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Please photograph:
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What are the areas of non conformance?
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Please photograph the non conformance
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What is the observation?
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Please photograph the observation
TOILETS
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Sinks
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Please photograph:
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What is the observation?
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Please photograph the observation
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What are the areas of non conformance?
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Please photograph the non conformance
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Urinals/W.C.s
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Please photograph:
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What is the observation?
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Please photograph the observation
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What are the areas of non conformance?
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Please photograph the non conformance
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Fittings
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Please photograph:
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What is the observation?
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Please photograph the observation
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What are the areas of non conformance?
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Please photograph the non conformance
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Floor
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Please photograph:
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What is the observation?
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Please photograph the observation
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What are the areas of non conformance?
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Please photograph the non conformance
PAPERWORK
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Specification
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What is the observation?
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What are the areas of non conformance?
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Work Instruction
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What is the observation?
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What are the areas of non conformance?
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Training Sheet
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What is the observation?
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What are the areas of non conformance?
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Dilution Rates
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What is the observation?
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What are the areas of non conformance?
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Period Task Record
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What is the observation?
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What are the areas of non conformance?
CONCULSION
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Summary:
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Additional Cleaning Requirements:
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Action to be taken:
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Supervisors Signature:
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Date:
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Managers Signature:
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Date:
