Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Maintenance Department/Contractor

  • Date

  • Choose your site

  • Time started

  • Time Finished work

  • Risk Rating

  • Capture.JPG
  • Work performed by : Name and Signature

  • If Contractor GF contact to sign as well

  • Location work was done

  • Equipment that was worked on - be specific

  • Description of work

  • Have all tools been counted and reconciled and put back in Toolbox or appropriate location ?

  • Has all equipment and surrounding areas been cleaned ?

  • Have you physically checked equipment and surrounding area for Foreign Matter ?

  • Has a temporary repair been made ?

  • If yes to temporary repair was done has it been logged ?

  • I am satisfied that the area has been left in a clean and food safe condition.

  • I have handed over to -

Cleaner to complete if applicable.

  • Has cleaning been completed and line inspected ?<br>Cleanliness, loose items, foreign matter.

  • I am satisfied that the area has been left in a clean and food safe condition Name and Signature

Production Department

  • Has line been inspected ?

  • I am satisfied that the area is clean, no loose items, no foreign matter.

  • If unacceptable state what further action is required and record any further work done before signing off.

  • Line was handed to me and all work and cleaning is complete ? Enter name and sign that production is ready to start.

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.