Title Page
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Conducted on
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Prepared by
Store Details
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Store Name:
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Store Number:
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Checkout Type:
- Pan Oston Input Belt Only
- Pan Oston Input & Output Belt
- Harr 2004 Input Belt Only
- Harr 2004 Input & Output Belt
- Harr 2000 Input Belt Only
- Harr 2000 Input & Output Belt
- Clares 2000 Input Belt Only
- Clares 2000 Input & Output Belt
PPM Details:
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PPM Date:
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PPM Engineer/Engineers
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Photo of signing in book:
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Audit Date
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PPM Checklist Input & Output Belted Checkout
Add Checkout
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Checkout Number Being Audited
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Asset Number
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Photo of Asset Number
Electrical Components:-
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Checkout Controller Fully Operational ?
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Detail Controller Faults
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Input Belt Safety Flap Sensor Working ?
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Output Belt Safety Flap Sensor Working ?
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Input Belt Eye Beam/Beams Working ?
Input Belt:-
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Input Belt Condition ?
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Stainless Nose Cone Cover Cleaned ?
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Photo
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Stainless Side Trims Cleaned ?
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Photo
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Stainless Eye Beam Trim Cleaned ?
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Photo
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Input Belt Stainless Safety Flap Cleaned ?
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Photo
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Input Belt Eye Beam/Beams Cleaned?
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Photo’s
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Input Belt Eye Beam reflector cleaned ?
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Photo
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Input Belt Motor Roller Cleaned?
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Photo
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Input Belt Idle Roller Cleaned?
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Photo
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Input Belt Checkout Bed Cleaned?
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Photo
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Input Belt Crumb Tray Cleaned?
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Photo
Output Belt:-
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Output Belt Condition ?
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Output Belt Stainless Safety Flap Cleaned ?
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Photo
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Output Belt Motor Roller Cleaned?
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Photo
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Output Belt Idle Roller Cleaned?
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Photo
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Output Belt Checkout Bed Cleaned?
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Photo
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Output Belt Crumb Tray Cleaned?
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Photo
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PPM Checklist Input Belted Checkout Only
Checkout
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Checkout Number Being Audited
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Asset Number
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Photo of Asset Number
Electrical Components:-
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Checkout Controller Fully Operational ?
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Detail Controller Faults
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Input Belt Safety Flap Sensor Working ?
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Output Belt Safety Flap Sensor Working ?
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Input Belt Eye Beam/Beams Working ?
Input Belt:-
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Input Belt Condition ?
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Stainless Nose Cone Cover Cleaned ?
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Photo
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Stainless Side Trims Cleaned ?
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Photo
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Stainless Eye Beam Trim Cleaned ?
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Photo
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Input Belt Stainless Safety Flap Cleaned ?
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Photo
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Input Belt Eye Beam/Beams Cleaned?
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Photo’s
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Input Belt Eye Beam reflector cleaned ?
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Photo
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Input Belt Motor Roller Cleaned?
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Photo
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Input Belt Idle Roller Cleaned?
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Photo
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Input Belt Checkout Bed Cleaned?
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Photo
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Input Belt Crumb Tray Cleaned?
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Photo
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PPM Completed as per job description?
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Detail Issues:
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Auditors Comments/Snags/Notes
Photos
Checkout Photo’s
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Add photo’s of checkouts: