Information
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Conducted on
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MRI Site
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Conducted On
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Conducted By
EMERGENCY EXIT LIGHTS
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If you have Answered NO to any of the questions, give details and ENSURE you REPORT any Faults to either the SHEQ Representative or the Operations Manager for immediate action.
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OR if the issue is a SAFETY RISK create a HICAR and upload the completed report to the HICAR.
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NSW Site Layout
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Exit Light 1 - Is the exit light switched on, clear and in good working order?
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Exit Light 2 - Is the exit light switched on, clear and in good working order?
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Exit Light 3 - Is the exit light switched on, clear and in good working order?
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Exit Light 4 - Is the exit light switched on, clear and in good working order?
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Exit Light 5 - Is the exit light switched on, clear and in good working order?
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Exit Light 6 - Is the exit light switched on, clear and in good working order?
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Exit Light 7 - Is the exit light switched on, clear and in good working order?
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Exit Light 8 - Is the exit light switched on, clear and in good working order?
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Exit Light 9 - Is the exit light switched on, clear and in good working order?
NOTES / COMMENTS
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ADD Notes / Comments / Any relevant Information
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PLEASE Sign your name and enter the time you completed the Audit.
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Audit Conducted By
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Completion Date
