James Feakes

Marandoo C/S Wash down sign off

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Title Page

Conducted on
Prepared by

Why?
Location
Has all hang up been removed?
Why?
Please Take Photo
Please take photo
Is the Deflector clear of all product?
Why?
Please Take Photo
Please take photo
Has the conveyor, feeder or screen above been run clear of product or hosed back and boarded to prevent engulfment?
Why?
Please take photo
Please take photo
Is the entrance way clear of hazards and items that could restrict access?
Why?
Please take photo
Please take photo
Is this confined space safe and ready for work to commence.
Why?
Conditions
Please take photo
Supervisor Sign off
Supervisor Sign off

James Feakes

Marandoo C/S Wash down sign off

Use this Template

Print as PDF

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.