Horsham Rural City Council Transfer Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

GENERAL INFORMATION

• Date and Time inspection began

  Date

• Premises Number

• Name of Premsies

• Address of Premises

• Phone Number

• Name of Propeitor or staff in attendance

• Name of Officer

  Luke Mitton

  Helene Wortley

PREMISES TYPE

• Act

  Food Act 1958

  Public Health and Wellbeing Act 2008

  residentail Tenancies Act 1997

• Premsies Type

  Select Food Premises Skin Penetration Hairdresser Beauty Therapist Accommodation Caravan park

  • Food Premises
  • Skin Penetration
  • Hairdresser
  • Beauty Therapist
  • Accommodation
  • Caravan park

AREAS INSPECTED

• Describe the areas inspected

COMMENTS/ACTIONS TO BE TAKEN

• Input additional comments and actions here

• Photos?

  Media

SIGNATURE

• Signature of Officer

  Sign