Title Page

  • Document No.

  • Conducted on

  • Prepared by

  • Completed on

Plant Room

  • Are Plant Room free from rubbish and consumable items

  • Vicinitee Reference for faults

  • Take Photos of any irregularities

  • Is Lighting all operational and clean

  • Vicinitee Reference for faults

  • Take Photos of any irregularities

  • Is all relevant signage in place and clean

  • Vicinitee Reference for faults

  • Take Photos of any irregularities

  • Are all doors in order as per 5 step check

  • Vicinitee Reference for faults

  • Take Photos of any irregularities

  • Is fabric in good condition

  • Vicinitee Reference for faults

  • Take Photos of any irregularities

  • Are all Fire Break Glasses in order with Fire Action Notices

  • Vicinitee Reference for faults

  • Take Photos of any irregularities

  • Are all eye wash stations and first aid boxes in date and fully stocked

  • Vicinitee Reference for faults

  • Take Photos of any irregularities

  • Is all plant equipment free from faults

  • Vicinitee Reference for faults

  • Take Photos of any irregularities

  • Are all materials and objects stored without risk of falling to cause injury

  • Vicinitee Reference for faults

  • Take Photos of any irregularities

  • Are pedestrian areas free from potential slip and trip hazards

  • Vicinitee Reference for faults

  • Take Photos of any irregularities

  • Are all unavoidable obstructions padded and marked/signed as hazards

  • Vicinitee Reference for faults

  • Take Photos of any irregularities

  • Are all hazardous substances securely stored

  • Vicinitee Reference for faults

  • Take Photos of any irregularities

  • Sign when completed

Receptions

  • Are Receptions all free from rubbish

  • Vicinitee reference for faults

  • Take photos of any irregularities

  • Is lighting fully operational

  • Vicinitee reference for faults

  • Take photos of any irregularities

  • Are all signage correct and in place

  • Vicinitee reference for faults

  • Take photos of any irregularities

  • Is the facade in good condition

  • Vicinitee reference for faults

  • Take photos of any irregularities

  • Are all entrance doors clean and in good working order

  • Vicinitee reference for faults

  • Take photos of any irregularities

  • Are Break Glasses and Fire Notices clearly displayed and clean

  • Vicinitee reference for faults

  • Take photos of any irregularities

  • Sign when completed

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.