Machine Fault / Maintenance Reporting

• Name

• Location of the Workplace
  Address

• Date

  Date

• Line Manager Responsible

• Machine(s) (Description)

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• Description of any faults found.

• Photo of the machine faults (optional).

  Media

Machine Recommissioning

• What repairs have been made to the machine(s) / equipment?

• Was an external supplier required to complete the repairs

  Yes

  No

  N/A

• Which company was used?

• Date of completion

  Date

• I confirm the machine(s) is safe and fit for use.

  Compliant

  Non-Compliant

  N/A

• Name and Signature of Reviewer

  Sign