Manager Inspection

• Facility Number:

• Work Order Number:

• Work Order Completion Date:

• Manager's Name:

• Employees Name:

• Type of Service Order Inspected:

  Select Preventative Maintenance Service Order Collection Work Order

  • Preventative Maintenance
  • Service Order
  • Collection Work Order

Completed Work Order Inspection

• Quality (Workmanship)

  Select Very Satisfied Satisfied Dissatisfied

  • Very Satisfied
  • Satisfied
  • Dissatisfied

• Was the job completed in an Efficient and Timely manner?

  Yes

  No

  N/A

• Was the job site cleaned and restored to it's original condition?

  Yes

  No

  N/A

• Was additional work found and reported correctly?

  Yes

  No

  N/A

• Was paper work completed accurately with sufficient detail?

  Yes

  No

  N/A

• Was the customer notified the work was completed?

  Yes

  No

  N/A

• Was the job previously inspected during "In-Progress Phase"?

  Yes

  No

  N/A

In Progress Work Order Inspection

• Quality (Workmanship)

  Select Meets Standards Needs Improvements Unacceptable

  • Meets Standards
  • Needs Improvements
  • Unacceptable

• Are all the employees wearing proper PPE?

  Safe

  At Risk

  N/A

• Is the Task Assessment filled out correctly?

  Yes

  No

  N/A

• Are all the employees L&Es up to date?

  Yes

  No

  N/A

• Is a permit required and present on the job?

  Yes

  No

  N/A

• Permit

  Select Confined Space Entry Dig Permit Burn Permit

  • Confined Space Entry
  • Dig Permit
  • Burn Permit

• Is the JSA being followed and/or are tasks assessed properly?

  Yes

  No

  N/A

• Is special safety equipment required?

  Yes

  No

  N/A

• Special Safety Equipment

  Select LOTO Fall Protection

  • LOTO
  • Fall Protection

• Is this a multifunction team requirement?

  Yes

  No

  N/A

• Are the correct tools being utilized and in the proper manner?

  Yes

  No

  N/A

Comments

• Add signature

  Sign

• Select date

  Date