Title Page

  • Site conducted

  • Conducted on

  • Lead Auditor

  • Location
  • Instrument Serial Number

  • Instrument type

  • Activity type

  • Audit executed by

  • Audited person

Instrument Status and General conditions

  • UPS precence and properly connection

  • Magneto thermic switch

  • Wiring situation

  • Cleanliness

  • Waste system

  • General exterior look (visual scratch, damage, label attached, etc...)

  • General conditions

  • Sw version installed

  • Version recorded matching

  • Other

EHS, PPES AVAILABILITY AND KNOWLEDGE (GOP 23.7052-TN LXL90-TN LSN318), SPARE PART MANAGEMENT AND DECONTAMINATION

  • Normal coat (cotton or disposable) availability

  • Spray Guard disposable coat availability

  • Biohazard light gloves availability

  • Biohazard medium/heavy gloves availability

  • Mechanical protection gloves availability

  • Protective Goggles availability

  • Facial Shield availability

  • Disposable surgical mask availability

  • Disposable FFP2-FFP3 availability

  • Protective Heavy Shoes availability

  • PPEs usage according to current activity availability

  • Hypotetical situation PPE usage (PM: cleaning and decontaminate of the covers and other surfaces included inner parts of modules)

  • Hypotetical situation PPE usage (Repair:Replacement of washer module assembly with tubing removal)

  • Decontamination procedure knowledge (Service manual reference and or additional documentation)

  • Other

AUDITEE IN FIELD BEHAVIOUR AND OTHER GENERAL AND OPERATIVE KNOWLEDGE (GOP Corp-GOP-000053 ex 23.6015- Corp-GOP-000056 ex 23.6066)

  • Dressing and ID plate

  • Specific Activity ongoing knowledge

  • Working area Set

  • Tools management before usage

  • Tools management after usage

  • Local LAB rules awareness

  • Service SW management (spare part, signature, RGA/OBF, Tools, etc...) knowledge

  • Spare part returnable (GOP 23.7201) knowledge

  • Apparound Situation

  • Car Stock Situation

  • General Behaviour Evaluation

  • Data Transfer and protection

CUSTOMER DOCUMENTATION AND FEEDBACK (LXL TN006-LSN TN322)

  • Electronic documentation

  • Hard copy documentation

  • Customer feedback

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.