Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
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Dishwasher dispenser required?
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Dishwasher model
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Space to install?
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Chemical to be hooked up
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Comments
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Sink pump required
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Space to install sink pump
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Chemical to be hooked up
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Comments
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Water fed dispensing required?
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Space to install
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Water connection
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Chemical to be hooked up
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Comments
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Soap dispensers required?
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Hand towel dispensers required?
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Toilet paper dispensers required?
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Current dispensing and compliance photos
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Wall charts required?
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Product list for wall chart
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SDS folder required?
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Product list for safety data sheets
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Printed bottles required?
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Product list for printed bottles with count
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Account set up?
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Online ordering required?
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Free on load agreement for dispensing required?
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Critical OH&S risks observed
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Steps for improvement
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Additional comments