Title Page
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Site conducted
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Store Number:
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Store Name:
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Completed by
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Conducted on
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Location
Cleaning Cupboards
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Please provide a photo of the cleaning cupboard.
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Please provide a photo of the noticeboard.
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Are all chemicals stored in a safe place?
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Are all bottles labelled correctly?
Washroom Facilities
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How many cubicles/urinals are in the gents facilities?
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How many cubicles are in the female facilities?
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Is there any Initial equipment still installed?
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Please provide details
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Please provide a photo of the equipment
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Number of PHS air fresheners
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Number of PHS toilet roll holders
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Count of PHS sanitary bins
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Count of PHS Water Management systems installed
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Is any PHS equipment damaged?
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Please provide details
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Please provide a photo of the equipment
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Are there any missing PHS keys for dispensers?
Machinery
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Please list the machinery in store and quantities (including serial number)
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Please provide a photograph of the machinery currently in store
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Please provide a photo of the asset tag on each machine
Finalize Audit
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Client name and position
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Client signature
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Signature
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Photograph of signature
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GSA Signature
