Title Page
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Site conducted
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Document No.
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Conducted on
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Audit Title
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LOCATION
- WIDNES
- HANSON ROAD
- HULL
- NEWCASTLE
- CARLISLE
- PENNINE
- LEICESTER
- STOKE
- ON SITE
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date
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operative name
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undefined
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employee number
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undefined
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type of test
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are there any items to be pat tested
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tested item
tested item
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make
- dewalt
- bosch
- makita
- milwaulkee
- worx
- black and decker
- hilti
- evolution
- ryobi
- erauber
- other
- unknown
- hitachi
- macallister
- numatic
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enter make
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undefined
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voltage
- 110v
- 240v
- 240v-18v
- 240v-24v
- 240v-36v
- 240v-12v
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item description
- CHARGER
- EXT LEAD
- TRANSFORMER
- DRILL
- CIRC. SAW
- ANGLE GRINDER
- RECIP. SAW
- MITRE SAW
- TILE SAW
- MULTI TOOL
- PADDLE MIXER
- PLANER
- SANDER
- BREAKER
- CEMENT MIXER
- LIGHT
- HOOVER
- ROUTER
- JIG SAW
- COMPUTER
- PRINTER
- OTHER
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add description
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undefined
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who is the item owned by
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pass?
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take picture of fail sticker on item
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are there any ladders / hop ups that require inspection
ladder
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what is the type of ladder
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a frame or platform
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what is the class of ladder
- class 1
- class 2
- EN131 PROF
- EN 131 DOM
- EN14183
- UNKNOWN
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what is the construction of the ladder
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is the ladder equipped with locking devices
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are the locking devices intact and functioning
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are rungs, treads and stiles free from damage
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number of treads / rungs
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 12
- 14
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are feet and endcaps free from damage
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has the operative been issued with new feet?
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operative to sign to indicate they will fit new feet ASAP
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Add signature
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is the ladder free from any damage or contamination that would impair its safe use
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is the ladder free from modification
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is the ladder fit for use
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please take photo of fail sticker on ladder
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I declare that I have presented all electrical equipment that requires PAT testing, I understand that it is my responsibility if I acquire any other equipment that requires testing I will inform my manager so that testing can be arranged.
I declare that I have presented all ladders that require inspection, I understand that it is my responsibility if I acquire any other ladders that require inspection I will inform my manager so that inspection can be arranged. -
operatives signature
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INSPECTOR NAME
