Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

  • Dishwasher dispenser required?

  • Dishwasher model

  • Space to install?

  • Chemical to be hooked up

  • Comments

  • Sink pump required

  • Space to install sink pump

  • Chemical to be hooked up

  • Comments

  • Water fed dispensing required?

  • Space to install

  • Water connection

  • Chemical to be hooked up

  • Comments

  • Soap dispensers required?

  • Hand towel dispensers required?

  • Toilet paper dispensers required?

  • Current dispensing and compliance photos

  • Wall charts required?

  • Product list for wall chart

  • SDS folder required?

  • Product list for safety data sheets

  • Printed bottles required?

  • Product list for printed bottles with count

  • Account set up?

  • Online ordering required?

  • Free on load agreement for dispensing required?

  • Critical OH&S risks observed

  • Steps for improvement

  • Additional comments

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.