Title Page
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Document No.
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PUBLIC / STAFF TOILET CLEANING AUDIT
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WARD / AREA / DEPARTMENT
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Conducted on
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Prepared by
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Location
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Personnel
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TOILET AUDITED
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TOILET CLEANED AM?
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TIME CLEANED AM.
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TOILET CLEANED PM?
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TIME CLEANED PM.
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TOILET CLEANED EVE?
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TIME CLEANED EVE.
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TOILET CLEANED OTHER.
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TIME CLEANED OTHER.
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IS THE ENVIRONMENT CLEANED SATISFACTORILY
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HAVE ANY DAYS BEEN MISSED IN THE LAST WEEK
COMMENTS AND SIGN-OFF
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PHOTOGRAPHIC EVIDENCE
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COMMENTS
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SIGN-OFF