Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Customer Information

  • Customer Name

  • Site Location

  • Department

  • Enter time of departure from home / hotel

  • Enter time of arrival to site

  • Enter time of departure from site

  • Enter time of arrival home / hotel

Equipment Information

  • Machine Model Number

  • Machine Serial Number

  • Machine Asset Number

  • Photo of outside of machine

Visit Detail

  • Reason for visit

  • Commercial detail

Reported Fault

  • Machine working but with fault

  • Machine not working at all

Troubleshooting

  • Are all services to the machine live and being provided as required

Proposed solution to return the machine to fully operational condition

  • Can the machine be fixed during this visit?

  • Will a return visit be required?

Parts

  • We're any parts used during the visit? If so please list them with part numbers, descriptions and quantities

  • Are any parts required following your visit? Please detail providing part numbers, descriptions, photos if applicable and quantities

Visit Summary

  • Summary and any recommendations

  • Any photos to support findings or recommendations

  • Any drawings or sketches to support findings or recommendations

  • Is a return visit required?

  • Is a quotation required for additional items/work?

  • Travel time from site?

  • Did you have to pay to park? If so detail the cost below.

  • Sychem Engineer

  • Customer Authorised Person

Office Use Only

  • Parts Total

  • Total Travel Time (Hours)

  • Total Labour (Hours)

  • Call Out Fee

  • First Hour Charge

  • Subsequent Hour Charge

  • Over Night Expenses

  • Misc

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.