Inspection Record - Road Sweeping

• Conducted on

  Date

• Drivers Name

• Prepared by

• Map Location
  Address

• Which Street

• Procedures / Risk Assessments Followed

  Yes

  No

  N/A

• Driver Following Work Instructions

  Yes

  No

  N/A

• Have Streets Been Swept To Required Standards

  Yes

  No

  N/A

• All Maintenance Issues Completed And Cleared

  Yes

  No

  N/A

• Correct Break Times

  Yes

  No

  N/A

• Comments

Photos

• Insert all related photos

  Media

Cleaners signature

• Sign below

  Sign