Information

  • Client / Site

  • Conducted on

  • Prepared by

  • Personnel

FIELD INSPECTION

  • what is the hygien level??

  • Add media

  • undefined

  • what is the status of building interiors

  • Add media

  • undefined

  • CRAWLING INSECTS INFESTATION?

  • Add media

  • undefined

  • FLYING INSECTS INFESTATION

  • Add media

  • undefined

  • RODENTS INFESTATION ?

  • Add media

  • undefined

  • DOMESTIC PETS ?

  • Add media

  • undefined

  • INFESTATION LEVEL

  • undefined

  • MANWHOLES STATUS

  • undefined

PROPOSED SOLUTION

  • DEEP CLEANING, SANITIZING,VACCUMING IS REQUIRED

  • PERSONNEL HYGIENE SHOULD BE IMPROVED

  • MAINTENANCE IS REQUIRED

  • undefined

  • BAITING STATION REQUIRED

  • ULV TREATMENT

  • SPRAYING TREATMENT

  • BAITING SYSTEM REQUIRED

  • OTHERS

  • undefined

RECOMMENDATION

  • AUDITOR RECOMMENDATION

  • CUSTOMER COMMENTS

SIGNATURE

  • CUSTOMER SIGNATURE

  • STERIKEM REPRESENTATIVE 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.