Toilet Alarm Certificate of Inspection

• Document No:

• Customer

• Site Address
  Address

• Date

  Date

• Arrival Time

  Date

Inspection

• Toilet location

• Main controller, reset unit, pull cord and overdoor indicator in good condition with mains supply indicators on.

  Yes

  No

  N/A

• Audible sounder functions on testing alarm

  Yes

  No

  N/A

• Overdoor Indicator lit on testing alarm

  Yes

  No

  N/A

• Audible sounder functions on testing alarm

  Yes

  No

  N/A

• Alarm reset complete

  Yes

  No

  N/A

• Toilet Location

• Main controller, reset unit, pull cord and overdoor indicator in good condition with mains supply indicators on.

  Yes

  No

  N/A

• Audible sounder functions on testing alarm

  Yes

  No

  N/A

• Overdoor Indicator lit on testing alarm

  Yes

  No

  N/A

• Audible sounder functions on testing alarm

  Yes

  No

  N/A

• Alarm reset complete

  Yes

  No

  N/A

• Toilet Location

• Main controller, reset unit, pull cord and overdoor indicator in good condition with mains supply indicators on.

  Yes

  No

  N/A

• Audible sounder functions on testing alarm

  Yes

  No

  N/A

• Overdoor Indicator lit on testing alarm

  Yes

  No

  N/A

• Audible sounder functions on testing alarm

  Yes

  No

  N/A

• Alarm reset complete

  Yes

  No

  N/A

• Toilet Location

• Main controller, reset unit, pull cord and overdoor indicator in good condition with mains supply indicators on.

  Yes

  No

  N/A

• Audible sounder functions on testing alarm

  Yes

  No

  N/A

• Overdoor Indicator lit on testing alarm

  Yes

  No

  N/A

• Audible sounder functions on testing alarm

  Yes

  No

  N/A

• Alarm reset complete

  Yes

  No

  N/A

• Toilet Location

• Main controller, reset unit, pull cord and overdoor indicator in good condition with mains supply indicators on.

  Yes

  No

  N/A

• Audible sounder functions on testing alarm

  Yes

  No

  N/A

• Overdoor Indicator lit on testing alarm

  Yes

  No

  N/A

• Audible sounder functions on testing alarm

  Yes

  No

  N/A

• Alarm reset complete

  Yes

  No

  N/A

• Toilet Location

• Main controller, reset unit, pull cord and overdoor indicator in good condition with mains supply indicators on.

  Yes

  No

  N/A

• Audible sounder functions on testing alarm

  Yes

  No

  N/A

• Overdoor Indicator lit on testing alarm

  Yes

  No

  N/A

• Audible sounder functions on testing alarm

  Yes

  No

  N/A

• Alarm reset complete

  Yes

  No

  N/A

Test Completion

• Test result

  Satistactory

  Unsatisfactory

Signature

• Engineers Signature

  Sign

• Customer Signature

  Sign