Title Page

  • Department / Unit:

  • Date Small Plant Taken:

  • Name of Plant:

  • Plant I.D. Number:

  • Staff Name:

  • Employee Number:

  • Condition of Plant:


On Return

  • Date Returned:

  • Is the plant being returned clean and in good order

  • Tag and take to small plant mechanic

  • Condition of Plant:


  • Is there any additional information required?

  • Add Comments

  • Add Photographs

  • Completed by:

  • Select date

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.