Title Page

  • Store Name

  • Store No.

  • Conducted on

  • Prepared by

  • Location

Plant Room

  • Was plant room locked on entering?

  • COSH sheet on or by door?

  • Any evidence of of old refrigeration spares or rubbish?

  • Will plant room floor require painting?

  • Are store using plant room for storage?

  • Number of packs at store?

  • Is there more than one plant room?

  • Any visible signs of oil leakage?

  • Any visible signs of refrigerant leakage?

  • Additional Comments

  • Photo's

Plant

  • Are electrical panel doors shut on plant?

  • Are any compressors valved or switched off?

  • Oil levels good on plant?

  • Does any plant have heat harvester connected?

  • Is harvester operational?

  • Does any plant require replacing?

  • Additional Comments

  • Photo's

Pipe Services

  • Any signs of lagging failure

  • Any pipe work damaged in back of house areas?

  • Additional comments

  • Photo's

Condenser Area

  • Area clean and tidy

  • Humidity sensor operational

  • Any access issues?

  • Additional comments

  • Photo's

Condenser

  • Any fans switched off or removed?

  • Are condensers clean?

  • Do any condensers need replacing?

  • Additional comments

  • Photo's

Refrigerant

  • What refrigerants are being used at store

  • What Leak Detection is fitted?

  • Leak detection operating

  • Real zero valve caps used

  • Are 2016 F-Gas sheets present

  • Entrained volume information present

  • Additional comments

  • Photo's

Cold Storage

  • Any evaporators iced up?

  • Any evidence of drain leaks?

  • Additional information

  • Photo's

Miscellaneous

  • Additional items

  • Photo's

Refrigeration service provider - (This section to be completed by store)

  • Do they meet there SLA in normal hours?

  • Do they meet SLA outside of normal ours?

  • Score Refrigeration contractor - (1=poor 5=excellent)

  • Additional comments

  • Store representative

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.