Information
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
General Area
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Lighting adequate and operational?
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Ventilation is adequate?
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Electrical switches/sockets in good condition?
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Furniture safe and undamaged?
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Is the building secure?
Emergency
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Access and egress paths clear?
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Are first aid kits accessible?
Welfare areas
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Drains (floor and sink) clear and free flowing?
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Area free from pests or evidence thereof
Validation information
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Affected area / item
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- lounge
- dining room
- kitchen
- hallway
- toilet
- study/office
- conservatory
- master bedroom
- bedroom 2
- bedroom 3
- bedroom 4
- bedroom 5
- ensuite
- bathroom
- loft/bedroom
- garden front and or rear
- garage/ shed
- other
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Scope
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Works completed to date?
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Additional works required, number of techs and timeframe?
Sign Off
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On site representative
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Auditor's signature
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