Inspection Record - Illegal Dumping

• Site conducted

  Select

• Conducted on

  Date

• Officers Name

• Prepared by

• Map Location
  Address

• Extra Location Information

• PreStart/Post Check Filled Out

  Yes

  No

  N/A

• Log Book Filled Out

  Yes

  No

  N/A

• Bowls/Cisterns Clean

  Yes

  No

  N/A

• Urinals Clean

  Yes

  No

  N/A

• Hand basins/taps Clean

  Yes

  No

  N/A

• Procedures / Risk Assessment followed?

  Yes

  No

  N/A

• On Site Crane Risk Assessment?

  Yes

  No

  N/A

• MUTCD works as per CCOM diagrams and procedures?

  Yes

  No

  N/A

• Has work been completed to required standards?

  Yes

  No

  N/A

• Maintenance issues requiring attention?

  Yes

  No

  N/A

• Correct break times?

  Yes

  No

  N/A

Photos

• Insert all related photos

  Media

Cleaners signature

• Sign below #1

  Sign

• Sign below #2

  Sign