Title Page
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Period of Inspection
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Area of Inspection
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Prepared by
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Any Other Personnel Present
Fire Safety Systems
Fire Resisting Doors & Means Of Escape
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Fire door vision panels are in good condition and clear of obstructions
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Fire door has 3 or more Hinges which are secure with no screws missing
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Fire doors have intumescent seals which are in good condition (not painted, missing or damaged)
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Fire door handles are secure, functioning correctly and can be opened without the use of a key
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No signs of wedging/chocking open doors
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Self closing devices are fixed to door and frame securely
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Fire doors close fully & shut tight by use of its own Self Closing (SC) Device
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Fire exit signage in place
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Fire alarm call points accessible and free from damage
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Fire action notices in place and legible
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Emergency arrangements in place for all persons with a disability
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Name and Signature of Inspector
Fire Extinguisher
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The operating instructions of each extinguisher are clean, legible and face outwards
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The seals and tamper indicators of each extinguisher are not broken and missing
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The reading of any pressure gauge or indicator fitted to an extinguisher is within operational and safety limits
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Each extinguisher has not been operated and is not obviously damaged or has any missing parts
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Each extinguisher is correctly located, suitably serviced and in the designated place
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Each extinguisher is unobstructed, visible and has relevant ID signage above them
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Name and Signature of Inspector
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Date of Inspection
Emergency Lighting
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Emergency Lighting Test
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Date of Test
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Name and Signature of Tester
Fire Prevention & Electrical Safety
Fire Prevention
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Area clear of combustible materials
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No smoking policy is being observed
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Waste bins being emptied regularly
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Ceiling tiles in place
Electrical Safety
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Wall socket outlets undamaged
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Portable electrical equipment in use with current PAT
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Multi socket extension leads are being used correctly (e.g. no multi sockets plugged into other multi sockets/adaptors and not exceeding permitted amps)
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Power cables safely routed and in good repair (No fraying, damage or exposed wires)
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Name and Signature of Inspector
Asbestos
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Are all known locations of Asbestos in good state of repair?
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Name of inspector
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Date of Inspection
Ladders, Pallet Trucks and Trolleys
- Ladders
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Ladder ID number & Location
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Plant / ID Number clearly legible and marking intact
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No loose, cracked or broken rungs, rails, braces or ropes
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No loose nails, screw bolts or other parts
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No splintered or sharp edges
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No damaged or worn non-slip steps or base
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No foreign matter on the ladder such as grease, oil, paints
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No loose, defective, broken or missing extension locks
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Hinge spreaders not loose or bent (stepladders / trestles)
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Stop guard on hinge spreaders not broken or damaged (stepladders / trestles)
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Retaining cords are of equal length and in good condition
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No damage or worn stiles (warping, sagging or distortion)
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Stable when open and standing on a level base (Stepladders)
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Name/Signature of inspector
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Date of Inspection
Trolley
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Trolley ID number & Location
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Wheels are in good repair
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Handle
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Bolts and fasteners
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Any other signs of defects or damage
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Name/Signature of inspector
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Date of Inspection
Outdoor Play Equipment
- Play Equipment
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Take photo of structure or identify equipment
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Structure is free of bending, warping, cracking, loosening and breaking
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Surface finish adequate (protective coating missing, rust or other corrosion, cracks, splinters, broken or open joints.)
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All items such as nuts, bolts washers, shackles etc are adequate (not missing, bent, broken, loosened, worn, open hooks, etc.)
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Edges are free of protrusions, sharp points or sharp edges
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No pinch or crush points present(Exposed mechanisms, junctures or moving components, etc.)
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Guard or hand rails/swing barriers aren't missing, bent, broken, loosened.
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Mechanical devices and moving parts checked for worn bearings, lack of lubrication, seizure or excessive motion, missing covers.
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Review swing and other seats (missing, damaged, loosened, sharp corners, insecure fittings, etc.)
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Look for missing or broken rungs, steps or treads loosening, etc.
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Foundations aren't cracked, loose in ground or exposed.
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Impact absorbing surfaces aren't compacted, displaced or not extensive enough to cover possible impact area
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Drain holes are clear
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Signature person carrying out inspection(s) of outdoor equipment
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Date/time of Inspection
Any Other Issues
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Defects Log
Issue
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