Title Page
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Conducted on
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Prepared by
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Location
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Store Name
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Store Number
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Store Address
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Have you signed in?
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Photo of the signing in book?
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Verisae WON
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Have you logged into Verisae?
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Screenshot of Verisae logged on
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Have you filled in the 'Permit To Work' and if required 'Roof Permit'?
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Photo of the Permits
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Condenser Location
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Photos of Asset Tags to be cleaned
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Photos of Condensers BEFORE
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Photos of Condensers AFTER
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Photos of floor area after
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Defects on condensers i.e. rotten coils, fans not functioning etc
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Photo of condition of plant room i.e rubbish, old oil etc
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Have you closed the job on Verisae?
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Screenshot of job closed on Verisae.
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Do you have any near misses to report? If yes please submit the incident to nearmiss@onefacility.co.uk
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Store representatives signature
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One Facility Engineers Signature
