Squires Service Report

• Conducted on

  Date

• Prepared by

• Location
  Address

Disclaimer

• The assessors believe the information contained within this risk assessment report to be correct at the time of printing. The assessors do not accept responsibility for any consequences arising from the use of the information herein. The report is based on matters which were observed or came to the attention of the assessors during the day of the assessment and should not be relied upon as an exhaustive record of all possible risks or hazards that may exist or potential improvements that can be made. Information on the latest workers compensation and OHS / WHS laws can be found at the relevant State WorkCover / WorkSafe Authority

Confidentiality Statement

• In order to maintain the integrity and credibility of the risk assessment processes and to protect the parties involved, it is understood that the assessors will not divulge to unauthorized persons any information obtained during this risk assessment unless legally obligated to do so

Table of Contents

• Audit - 0/8 - 0%

  Yes

  No

  N/A

• Question

  Yes

  No

  N/A

Response

Details

• Type of Call

Service Call

After Hours Call Out

• Quoted job

  Yes

  No

  N/A

• Work order number

• Job Description

Customer

• Site Address

Site Risk Assessment

• Is a Site Risk Assessment needed on this job?

  Yes

  No

  N/A

• Service Performed

  Yes

  No

  N/A

• Date & Hours

Materials & Sub Contractors

• Was Materials & Sub Contractors used on this job

  Yes

  No

  N/A

• Refrigerant

  Yes

  No

  N/A

• Was Refrigerant used on this job?

  Yes

  No

  N/A

Equipment & Sundries

• Was other equipment used on this job?

  Yes

  No

  N/A

• Job Completed

  Yes

  No

  N/A

• Checked & Approved for Invoice

  Yes

  No

  N/A