Reliability - Hand back to Production after Breakdown.

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Maintenance Department/Contractor

• Date

  Date

• Choose your site

  Select

• Time started

  Date

• Time Finished work

  Date

• Risk Rating

• 

• Work performed by : Name and Signature

  Sign

• If Contractor GF contact to sign as well

  Sign

• 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 ?

  Yes

  No

  N/A

• Has all equipment and surrounding areas been cleaned ?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Has a temporary repair been made ?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Sign

• I have handed over to -

  Production

  Cleaner (if applicable)

Cleaner to complete if applicable.

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

  Yes

  No

  N/A

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

  Sign

Production Department

• Has line been inspected ?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• 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.

  Sign