New Dos Chocolate Factory

• Conducted on

  Date

• Conducted by

• Site conducted

  Select
Asset

• Asset Condition

  Safe

  At Risk

• Describe the present asset condition

• Performance

  Select Excellent Good Fair Poor

  • Excellent
  • Good
  • Fair
  • Poor

• Yes

  No

• Yes

  No

• Yes

  No

• Yes

  No

• Clean

  Select Yes No

  • Yes
  • No

• Yes

  No

• Yes

  No

• 1st Calibration Rating (1-100)

• 2nd Calibration Rating (1-100)

• Average Calibration Result

• Picture of the Area where the Asset is Located (make sure that the asset is included in the photo)

  Media

• Add media

  Media

• Sample picture of an asset in the area

  Drawing
Temperature of the Area

• Is this present?

  Select Yes No

  • Yes
  • No

• What went wrong?

  Select Screw Rivets

  • Screw
  • Rivets

• Asset Condition

  Safe

  At Risk

• Describe the present asset condition

• Performance

  Excellent

  Good

  Fair

  Poor

• Clean

  Yes

  No

• 1st Calibration Rating (1-100)

• 2nd Calibration Rating (1-100)

• Average Calibration Result

• Picture of the Area where the Asset is Located (make sure that the asset is included in the photo)

  Media

• Is the asset hazardous to use?

  Hazardous and can't be fixed

  Hazardous but can be fixed

  Safe to use

• Why do you say so? and How safe?

• Hazards Present

  Select Physical Chemical Microbiological N/A

  • Physical
  • Chemical
  • Microbiological
  • N/A

• Physical Hazards

  Select

• Chemical Hazards

  Select Food Additives Working with Chemicals Raw material exposure N/A

  • Food Additives
  • Working with Chemicals
  • Raw material exposure
  • N/A

• Microbiological Hazards

  Select Fecal microbiota Industry water N/A

  • Fecal microbiota
  • Industry water
  • N/A
Other Hazards

• undefined

undefined

• Yes

  No

• Signature

  Sign

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