Title Page

  • Document No.

  • Audit Title

  • Inspection Date/Time

  • Inspectors

  • Inspection Areas:
    Area 1: A/B 200, A/B 300, A/B/C Junction 400, A/B 500
    Area 2: C200 (Library workroom), C/CH/D 300, C/D 400
    Area 3: E100 (basic: lobby; thorough: lobby and studio), E/F 200, E/F 300, E/F 400
    Area 4: G200, G300, G400 (plus CH100 - basement & mechanical room - during thorough)
    Area 5: CH200 (includes kitchen & serving areas), External, L700 Attic during thorough

  • Please indicate inspection area:

Item 1

  • Location
  • Hazard Observed

  • Hazard Class

  • Picture of the hazzard

  • Repeat?

Item 2

  • Location
  • Hazard Observed

  • Hazard Class

  • Picture of the hazzard

  • Repeat?

Item 3

  • Location
  • Hazard Observed

  • Hazard Class

  • Picture of the hazzard

  • Repeat?

Item 4

  • Location
  • Hazard Observed

  • Hazard Class

  • Picture of the hazzard

  • Repeat?

Item 5

  • Location
  • Hazard Observed

  • Hazard Class

  • Picture of the hazzard

  • Repeat?

Item 6

  • Location
  • Hazard Observed

  • Hazard Class

  • Picture of the hazzard

  • Repeat?

Item 7

  • Location
  • Hazard Observed

  • Hazard Class

  • Picture of the hazzard

  • Repeat?

Item 8

  • Location
  • Hazard Observed

  • Hazard Class

  • Picture of the hazzard

  • Repeat?

Item 9

  • Location
  • Hazard Observed

  • Hazard Class

  • Picture of the hazzard

  • Repeat?

Item 10

  • Location
  • Hazard Observed

  • Hazard Class

  • Picture of the hazzard

  • Repeat?

Item 11

  • Location
  • Hazard Observed

  • Hazard Class

  • Picture of the hazzard

  • Repeat?

Item 12

  • Location
  • Hazard Observed

  • Hazard Class

  • Picture of the hazzard

  • Repeat?

Item 13

  • Location
  • Hazard Observed

  • Hazard Class

  • Picture of the hazzard

  • Repeat?

Item 14

  • Location
  • Hazard Observed

  • Hazard Class

  • Picture of the hazzard

  • Repeat?

Item 15

  • Location
  • Hazard Observed

  • Hazard Class

  • Picture of the hazzard

  • Repeat?

Final Comments

  • Comments

  • JHSC Signature #1

  • JHSC Signature #2

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