Title Page

  • Conducted on:

  • Conducted by:

  • Select the Line (1-4) Metal Detector Used to conduct the pass:

Check locations for new lot numbers:

  • Line 1 Break Room (First aid kit /PPE Station)

  • Mothers Room (First aid kit)

  • Line 3 Break Room (First aid kit /PPE Station)

  • Sanitation Locker Room nexxt to Training Room p1 (First aid kit)

  • Maintenance Shop P1

  • L2-L3 hygiene Junction

  • WH Dock

  • Front Desk

  • Line 4 Break Room/Locker Room (First Aid Kit/PPE Station)

  • Maintenance Shop P2

  • P1 Supervisor Office

  • P2 #1 FA box

  • P2 #2 FA box Warehouse

  • P2 #3 FA box

  • P2 #4 FA box Outside of Maintenace

  • P2 #5 FA box pkg ped walkway

  • P2 #6 FA box Treatment Room

  • P1 L3 Hyg Junction

  • P2 Lunch Room

  • Was the MD log updated.

Item Verification

  • Material Type:

  • Lot Number:

  • 1st PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • 2nd PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • 3rd PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • Material Type:

  • Lot Number:

  • 1st PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • 2nd PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • 3rd PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • Material Type:

  • Lot Number:

  • 1st PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • 2nd PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • 3rd PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • Material Type:

  • Lot Number:

  • 1st PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • 2nd PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • 3rd PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • Material Type:

  • Lot Number:

  • 1st PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • 2nd PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • 3rd PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • Material Type:

  • Lot Number:

  • 1st PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • 2nd PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • 3rd PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • Material Type:

  • Lot Number:

  • 1st PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • 2nd PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • 3rd PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • Material Type:

  • Lot Number:

  • 1st PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • 2nd PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • 3rd PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • Material Type:

  • Lot Number:

  • 1st PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • 2nd PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • 3rd PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • Material Type:

  • Lot Number:

  • 1st PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • 2nd PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

  • 3rd PASS CONDUCTED:

  • If metal detector did not FAIL the item complete a corrective action?

Documentation of Completion

  • Completed by: Name , Title

  • Date & Time Completed:

  • Signed:

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