Housekeeping Audit

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Department / Audit Details

• Department Name

• Departmental Name

  Select Top Shed Category 3 Plant Garage Maintenance Boilerhouse Category 1 Plant Line 6 Line 7 Water Treatment Plant

  • Top Shed
  • Category 3 Plant
  • Garage
  • Maintenance
  • Boilerhouse
  • Category 1 Plant
  • Line 6
  • Line 7
  • Water Treatment Plant

• Department Manager

• Date and time of housekeeping audit

  Date

Issues Identified

• Fire Issues

  Safe

  At Risk

  N/A

• Slip / Trip / Fall Issues

  Safe

  At Risk

  N/A

• Electrical Issues

  Safe

  At Risk

  N/A

• Guarding Issues

  Safe

  At Risk

  N/A

• Other issue

  Safe

  At Risk

  N/A

• Other issue

  Safe

  At Risk

  N/A

• Other issue

  Safe

  At Risk

  N/A

• Other issue

  Safe

  At Risk

  N/A

• Other issue

  Safe

  At Risk

  N/A

• Other issue

  Safe

  At Risk

  N/A

• Other issue

  Safe

  At Risk

  N/A

• Other issue

  Safe

  At Risk

  N/A

• Other issue

  Safe

  At Risk

  N/A

• Other issue

  Safe

  At Risk

  N/A

• Other issue

  Safe

  At Risk

  N/A

• Other issue

  Safe

  At Risk

  N/A

• Other issue

  Safe

  At Risk

  N/A

• Other issue

  Safe

  At Risk

  N/A

• Other issue

  Safe

  At Risk

  N/A

Housekeeping Audit Accpetence

• Auditors Name

  Sign

• Audit Acceptors Name

  Sign