Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Location
  • Personnel

Customer Information

  • Customer name

  • Site location

  • Department

Times on site

  • Monday depart from home or hotel

  • Monday arrive on site

  • Monday depart from site

  • Monday arrive home or hotel

  • Any hotel or other expenses

  • Tuesday depart from home or hotel

  • Tuesday arrive on site

  • Tuesday depart from site

  • Tuesday arrive home or hotel

  • Any hotel or other expenses

  • Wednesday depart from home or hotel

  • Wednesday arrive on site

  • Wednesday depart from site

  • Wednesday arrive home or hotel

  • Any hotel or other expenses

  • Thursday depart from home or hotel

  • Thursday arrive on site

  • Thursday depart from site

  • Thursday arrive home or hotel

  • Any hotel or other expenses

  • Friday depart rom home or hotel

  • Friday arrive on site

  • Friday depart from site

  • Friday arrive home or hotel

  • Any hotel or other expenses

Equipment information

  • Machine make

  • Machine model

  • Machine serial number

  • Asset number

Visit Detail

  • Reason for visit

  • Commercial detail

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?

  • 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.