Quality Burleigh - Glass/Hard Plastic Register

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Standard Operating Procedure

• This audit is to be conducted regularly and is to enable an accurate Glass and Hard Plastic Check to be carried out. This is to be used in conjunction with the line specific audit.

• Date and Time of Report

  Date

Risk assessment

• Area where this audit is carried out ?

  Stores

  Production

  Packing

  Breadroom

• I am completing an audit of Glass/Hard Plastic items on the Burleigh Site ?

  Yes

  No

  N/A

• Matrix

  

Glass/Hard Plastic Items in Area

• Add Photo of the Glass/Hard Plastic Sighted.

  Media

• Rate the current condition from 0 to 3 0 - Broken and requires replacement 1 - Damaged 2 - Minor damage with no immediate risk 3 - Good Condition

• What is the Risk assessment rating for this item ?

  Low

  Medium

  High

  Extreme

Glass/Hard Plastic Items in Area

• Add Photo of the Glass/Hard Plastic Sighted.

  Media

• Rate the current condition from 0 to 3 0 - Broken and requires replacement 1 - Damaged 2 - Minor damage with no immediate risk 3 - Good Condition

• What is the Risk assessment rating for this item ?

  Low

  Medium

  High

  Extreme

Glass/Hard Plastic Items in Area

• Add Photo of the Glass/Hard Plastic Sighted.

  Media

• Rate the current condition from 0 to 3 0 - Broken and requires replacement 1 - Damaged 2 - Minor damage with no immediate risk 3 - Good Condition

• What is the Risk assessment rating for this item ?

  Low

  Medium

  High

  Extreme

Glass/Hard Plastic Items in Area

• Add Photo of the Glass/Hard Plastic Sighted.

  Media

• Rate the current condition from 0 to 3 0 - Broken and requires replacement 1 - Damaged 2 - Minor damage with no immediate risk 3 - Good Condition

• What is the Risk assessment rating for this item ?

  Low

  Medium

  High

  Extreme

Glass/Hard Plastic Items in Area

• Add Photo of the Glass/Hard Plastic Sighted.

  Media

• Rate the current condition from 0 to 3 0 - Broken and requires replacement 1 - Damaged 2 - Minor damage with no immediate risk 3 - Good Condition

• What is the Risk assessment rating for this item ?

  Low

  Medium

  High

  Extreme

Glass/Hard Plastic Items in Area

• Add Photo of the Glass/Hard Plastic Sighted.

  Media

• Rate the current condition from 0 to 3 0 - Broken and requires replacement 1 - Damaged 2 - Minor damage with no immediate risk 3 - Good Condition

• What is the Risk assessment rating for this item ?

  Low

  Medium

  High

  Extreme

Glass/Hard Plastic Items in Area

• Add Photo of the Glass/Hard Plastic Sighted.

  Media

• Rate the current condition from 0 to 3 0 - Broken and requires replacement 1 - Damaged 2 - Minor damage with no immediate risk 3 - Good Condition

• What is the Risk assessment rating for this item ?

  Low

  Medium

  High

  Extreme

Glass/Hard Plastic Items in Area

• Add Photo of the Glass/Hard Plastic Sighted.

  Media

• Rate the current condition from 0 to 3 0 - Broken and requires replacement 1 - Damaged 2 - Minor damage with no immediate risk 3 - Good Condition

• What is the Risk assessment rating for this item ?

  Low

  Medium

  High

  Extreme

Glass/Hard Plastic Items in Area

• Add Photo of the Glass/Hard Plastic Sighted.

  Media

• Rate the current condition from 0 to 3 0 - Broken and requires replacement 1 - Damaged 2 - Minor damage with no immediate risk 3 - Good Condition

• What is the Risk assessment rating for this item ?

  Low

  Medium

  High

  Extreme

Glass/Hard Plastic Items in Area

• Add Photo of the Glass/Hard Plastic Sighted.

  Media

• Rate the current condition from 0 to 3 0 - Broken and requires replacement 1 - Damaged 2 - Minor damage with no immediate risk 3 - Good Condition

• What is the Risk assessment rating for this item ?

  Low

  Medium

  High

  Extreme

• If more items are detected in the area complete this audit form and initiate a second form for the same date and area.

• Investigation completed by ? name and Signature

  Sign