Title Page

  • Facility Name

  • Device and Activity description. Eg. APM1-TPH replaced

  • Prepared by (short name)

  • Conducted on

Activity

  • Time Started

  • Region

  • Facility name

  • Facility name

  • Facility name

  • Activity description

  • Category

  • Activity type

  • Assessment Result

  • Add parts/material used

  • Parts/Material
  • Part

  • Part Description

  • Article nr (or scan qr code)

  • Serial nr

  • Activity Completed

  • Client/Site Representative

  • Optional pictures

  • End time

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.