Monthly Inspection

• Document No.

• Site

• Conducted on

  Date

• Barry Donaghy Operations Manager Buttercrane Centre

  Sign

• Select date

  Date

Satisfactory-Specified Item in good and safe condition. Specified location is in good condition and area is clean,clear and safe (e.g. No slip or trip hazards, no litter)

Not Satisfactory-specified item/area is not in good and safe condition (action required)

N/A

General Health and Safety do the following meet Satisfactory requirements specified above? (add site specific information here - e.g. area,no of items)

• Store rooms (e.g. Cleaners)

  Yes

  No

  N/A

• Electrical cupboard / switchrooms

  Yes

  No

  N/A

• First aid kit

  Yes

  No

  N/A

• Defibrillator

  Yes

  No

  N/A

• Roller shutter doors

  Yes

  No

  N/A

• Guttering / pipework

  Yes

  No

  N/A

• Drains, gullies and manhole covers

  Yes

  No

  N/A

• Fixed ladders

  Yes

  No

  N/A

• Exterior stairs

  Yes

  No

  N/A

General Comments:

• Add signature

  Sign