• Client / Site

  • Conducted on

  • Prepared by

  • Location

Equipment Details

  • Equipment Description?

  • Equipment Reference Number?

  • Brief Description Of Problem?

  • Category Of Problem?

  • Action required?

  • Has the equipment got a red tie wrap on it?

  • Corrective Action Taken?

  • Corrective action taken by?

  • Preventative action taken for future use?

  • Photo of damage

  • Sketch

  • Any further comments


  • ACDC Staff Signature

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.