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Trans-Asia Shipping Lines, Inc. Revision No.

: 00
SAFETY MANAGEMENT SYSTEM FORMS Issued Date : 08/05/2019
Revision Date : 00/00/0000
Page Number : Page 1 of 1
RESTROOM MONITORING CHECKLIST Document :

S/A CHECKER S/A CHECKER S/A CHECKER S/A CHECKER S/A CHECKER
AREAS URINAL/TOILET REMARKS
FLUSHING TRASH CANS TORK TISSUE LAVATORY
BOWL
DATE: F C F C F C F C F C F C F C F C F C F C
1AM 1PM
2AM 2PM
3AM 3PM
4AM 4PM
5AM 5PM
TIME

6AM 6PM
7AM 7PM
8AM 8PM
9AM 9PM
10AM 10PM
11AM 11PM
12PM 12AM

S/A CHECKER S/A CHECKER S/A CHECKER S/A CHECKER S/A CHECKER
AREAS MIRRORS & GLASS REMARKS
HANDSOAP WALLS DOORS LIGHTS
WINDOWS
DATE: F C F C C C C C F C F C F C F C
1AM 1PM
2AM 2PM
3AM 3PM
4AM 4PM
5AM 5PM
TIME

6AM 6PM
7AM 7PM
8AM 8PM
9AM 9PM
10AM 10PM
11AM 11PM
12PM 12AM
Legend:
Prepared By: Checked By: S/A - Service Attendant/Utility
Checker - Could be the Hotel Officer/Deck Attendant
(Name & Signatures of Service Attendant) (Name & Signatures of Checker) assigned to Specific Deck Accommodation
C - Clean F - Functional
05/2019
00/0000
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MARKS

MARKS
Attendant
mmodation

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