Information
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Inspection No:
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Site/Location:
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Inspection commenced on:
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Report Prepared by:
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Personnel involved with inspection:
Percentage of Inspection Results
Section 1 - Documentation
1.1 - Safety Training and Inductions
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Training records present
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
1.2 Safe Work Instructions/Risk Assessments
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SWI & RA for chemicals/equipment/processes<br>
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Dated within last 3 years
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
1.3 Chemical Register/MSDS
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MSDS sighted/available found in Safety Database
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
1.4 Inspections
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Records present
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Evidence of actions
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
1.5 Emergency procedures
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Emergency booklet by phone
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Floor plan visible
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Area emergency procedure posted
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Wardens identified
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
Section 2 - Emergency Equipment
2.1 Safety showers/Eye wash
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Accessible (clear path)
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Operational
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Tested
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
2.2 Fire extinguishers
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Accessible
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Appropriate
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Tagged
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
2.3 First aid
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Kits within 20 metres
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Modules/size appropriate to area
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Stocked and within expiration date
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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First Aiders identified
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
2.4 Ergonomic Conditions
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Noise
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Lighting
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Ventilation
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Heat/Cold mitigation
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
Section 3 - Chemical, Waste - Storage and Handling
3.1 Storage
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Chemical stored according to Monash's guidelines
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Incompatibles segregated
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Chemicals in use labeled and stored in closed vessels
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Bulk storage - handling issues
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
3.2 Spill kits
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Available
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Appropriate to the substances present in work area
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Action(s) required
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Notes/Comments
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Person responsible
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To be completed by
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Checked by
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Date completed
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Spill management procedures visible
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
3.3 Gas cylinders & Gas lines
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Gas cylinders secured
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Connections secure and tubing suitable for pressure
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Appropriate gas detector is available
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Oxidising & Flammable gases segregated
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
3.4 Cryogenic liquids
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Stored in appropriate vessel
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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PPE available
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
3.5 Waste chemicals storage - labelled waste vessels
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Vented caps & Plastic bottles used unless chemically incompatible
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Notes/Comments
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Person responsible
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Action(s) required
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To be completed by
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Checked by
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Date completed
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Designated and labelled storage vessels
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
Section 4 - Other Hazards
4.1 Manual Handling
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Heavy items stored low
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Lifting devices available
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
4.2 Biological Hazard
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Are there any Biological hazards
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
4.3 Ionising radiation
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Is there any Ionising radiation
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
4.4 UV Radiation
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Is there any UV Radiation
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Action(s) required
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Notes/Comments
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Person responsible
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To be completed by
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Checked by
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Date completed
4.5 Lasers
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Are there any Lasers
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
4.6 Personal protective equipment
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Available
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Appropriate
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Condition
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
4.7 Signage
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Dangerous goods
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Personal protective equipment
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Hazard alert
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Permits to operate attached to rigs
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
Section 5 - Electrical and Machinery
5.1 Appliances
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Tested & tagged
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Condition
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
5.2 Fume Cupboards
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Sash height level with yellow diamond
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Tested annually
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Storage minimised and no items close to leading edge
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
5.3 Refrigeration/freezing devices used
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Used appropriately
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Signed where required
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Seals on doors are in good condition
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
5.4 Machines/rigs fitted with
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Guarding
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Emergency stop features
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Isolation capabilities
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
Section 6 - Housekeeping & Hygiene
6.1 Non power equipment (including glassware)
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Appropriately stored, used and in good condition
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
6.2 General area
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Is the general area clear from obstruction
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
6.3 Storage
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Are cupboards/racking/other storage devices utilised
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Bench storage minimised
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
6.4 Housekeeping (i.e doorways, aisles, landings)
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Floor space, exits, isles clear from obstruction
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Waste receptacles clearly identified
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Confirm there are no visible spills and stains
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Confirm appropriate cleaning supplies are available
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
6.5 No food in work area
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Confirm there is no food in the work area
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Notes/Comments
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Action(s) required
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Person responsible
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To be completed by
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Checked by
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Date completed
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Miscellaneous notes
Signed off
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Inspection Team Member
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Inspection Team Member
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Inspection Team Member
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Inspection Team Member
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Lead Inspector
