Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
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Downtime (Best time to maintain)
School Information
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EMIS
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School name
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Total number of students
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Principal title
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Principal Name & Surname
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Principal contact number / GDE Cellphone Number
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Suburb of School
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Email Address
Visual Inspection
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Who did the installation?
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What is the colour of the cage?
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Is the cage still in a good condition?
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Does it need to be replaced?
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Is the changeover still in a good condition?
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Is/Are the pigtails still in a good condition?
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What is the condition of the O-rings on the Pigtails?
- Good
- Fair
- Poor
- N/A
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Is the regulator still in good working order?
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Is the external shut-off valve still intact?
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Is the Internal shut-off valve still intact?
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Is the pipeline still intact and distinguishable (BEIGE COLOR/ LPG stickers on)?
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What is the condition of the Fire Extinguisher signs?
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What is the condition of the Fire Extinguisher?
- Due for maintenance
- NO extinguisher in kitchen
- Still in good condition
Maintenance performed
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Did you do a leak test on the regulator?
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Did you do a leak test on the pigtails?
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Did you test the pipeline for leaks?
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Did you replace LPG stickers on the pipeline / Paint the pipeline?
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Batho Pele Sign put up if worked on the line?
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How many stove are being Maintained?
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How many stoves are connected to the pipeline?
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Did you do a leak test on the stove manifolds?
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Did you remove and grease the jets on the stove manifolds?
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Did you clean the C40 burners with pipe cleaners?
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Did you wash & scrub the C40 burners?
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Did you remove all dust from the burners by using a compressed air gun?
SHE-Q Requirements
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Is there proper ventilation in the kitchen?
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Is there sufficient lighting in the kitchen?
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Is there running water in the kitchen?
- Yes
- No
- N/A
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Is there warm/hot water to clean/wash cooking utensils after food has been prepared?
- Yes
- No
- N/A
- Urn used to boil water
- Pots used to boil water
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Are there sufficient areas for the children to consume their meals during meal times?
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Are there shaded areas for kids to sit and eat their meals?
Consumables used
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Did you re-spray the stove with heat-resistant spray ?
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How much heat-resistant spray did you use?
- 1/4 can
- 1/2 can
- 1/3 can
- 1 can/s
- 2 can/s
- 3 can/s
- N/A
- 1/2 can/s
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How much gloss spray did you use?
- 1/4 can
- 1/2 can
- 1/3 can
- 1 can/s
- 2 can/s
- 3 can/s
- N/A
- 1/2 can/s
Costing Info
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How many hours did you work?
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How many kilometers did you travel?
School Logbook
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Please take picture of the logbook entry at the school
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School representative Name & Designation
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Maintenance End of Day Report
- Additional stove needed
- Stove to be replaced
- 2nd Stove to be replaced
- 3nd Stove to be replaced
- O ring Replaced
- FE Signs Put up (1)
- FE Signs Put up (2)
- Change Over Replaced (Whole part)
- Change Over Replaced (1 part)
- Training Required (LPG)
- Training Required (Fire Extinguisher)
- Urgent Call out Required
