Information
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Document No.
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OHS Inspection - Office
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Area/Dept Inspected
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Conducted on
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Management Assessor Name
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HSR Assessor Name
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Department Managers Name
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OHS Advisor Name
General Workplace Condition
Floors
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Clean & orderly
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Free of slip hazards
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Free of trip hazards
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Free of protrusions
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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If carpeted - In good condition
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Any mats are in good condition
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
Aisles and passageways
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Sufficient width for normal movement
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Clear and un-obstructed
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Well lit
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Good vision at intersections
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Mirrors in place at blind spots
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Free of slips, trips and fall hazards
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
Stairs
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Landings clear and un- obstructed
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Steps uniform in height and depth
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Handrails provided on open sides
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Slip resistant tread installed
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Well Lit
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
Exits and egress
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Sufficient exits for prompt escape
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Routes and exits clearly marked
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Exit and signs illuminated
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Approaches to exits un-obstructed
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Exits clear externally
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Exits open out wards onto level floor
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
Facilities
Water Supply
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Potable drinking water available
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
Toilet and shower facilities
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Adequate toilets (ie 1for every 20 People)
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Toilets and showers clean
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Cleaning and sanitising agents available
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Paper towels supplied
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
Dining facilities
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Dining/food preparation facilities available
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Maintained clean, tidy and hygienic
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Adequate seating provided
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
Waste disposal
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Adequate number of bins provided
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Bins emptied regularly
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
Materials
Stacking and storage
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Access to storage un-obstructed
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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All storage stable and secure against movement
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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All storage neat and orderly
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
Emergency systems
OHS Notice board
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First aider list displayed
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Emergency warden list displayed
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Area relevant safety information displayed
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Injury management information displayed
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
Emergency instructions
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Evacuation plan displayed
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Evacuation procedure on hand
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
Emergency siren alarm system
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Siren tested on a regular basis
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Siren audible in all areas of the department
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
Fire protection system
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Clear access maintained
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Extinguishers in designated position
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Extinguishers tested within the last 6 months
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Extinguishers are of the appropriate type
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Hose reels rolled neatly and tested regularly
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Sprinkler heads have adequate clearance
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
First aid
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First aid boxes/cabinets in place
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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First aid boxes/cabinets checked regularly
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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First aid boxes/cabinets adequately stocked
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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First aid boxes/cabinets adequately stocked
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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First aid boxes/cabinets contents "in date"
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Emergency numbers displayed
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
Electrical
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Power cords properly laid out and neat
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Equipment tested and tagged and in date
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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No double adapters used
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Electrical cabinets locked
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
Computer work stations
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Ergonomically set up
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Monitor positioned appropriately
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Operator comfort maintained
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
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Other
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Corrective action for sub standard condition
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By Whom:
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Add Photo for "To Standard" condition (optional)
Signatories
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Add signature
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Date & Time
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Add signature
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Date & Time
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Add signature
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Date & Time
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Add signature
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Date & Time
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Add signature
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Date & Time
