Information

  • Document No.

  • Enter site name & town - eg Homebase Hatfield

  • Prepared by

  • Conducted on

Store info

  • Store photo

  • Managers name

  • Store number

  • Maintenance carried out on

  • Maintenance carried out by

Plant status

  • Are there any outstanding quotes or known defects/issues?

Controls

  • Are the controls operational?

  • Does the manager know how to use the controls?

  • Have heating and cooling set points been set correctly for sales and stock areas?

Gas Maintenance

  • Have vents been cleaned?

  • Have filters been checked\cleaned?

  • Is all ventilation operational? (Other than quoted works)

  • Is a tightness test printout attached to the gas meter?

  • Are flue gas analyser printouts attached to each appliance?

  • Any other information?

Summary

  • Is all equipment operational? (other than quoted items)

  • Are there any health & Safety concerns?

  • Are plant areas clear of H&V related debris?

  • Are plant areas clear of store items?

Conclusion & signature

  • Auditors comments

  • Audit reviewed with

  • Their position is

  • Managers comments

  • How satisfied are you with the last service?

  • Signature

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.