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  • 26071-JO-HSE-023 Toilet Inspection Form

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    rio alfarisi
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    This is a toilet inspection form documenting a routine check of toilet facilities. It lists 7 components to inspect including the closet, floor, walls, faucet, door, and toilet water disposal system. Inspectors mark each component as clean or dirty and note any remarks. The form is signed by the inspector and acknowledged by health and safety staff.

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    26071-JO-HSE-023 Toilet Inspection Form (1)

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    This is a toilet inspection form documenting a routine check of toilet facilities. It lists 7 components to inspect including the closet, floor, walls, faucet, door, and toilet water disposal system. Inspectors mark each component as clean or dirty and note any remarks. The form is signed by the inspector and acknowledged by health and safety staff.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    8 views1 page

    26071-JO-HSE-023 Toilet Inspection Form

    Uploaded by

    rio alfarisi
    This is a toilet inspection form documenting a routine check of toilet facilities. It lists 7 components to inspect including the closet, floor, walls, faucet, door, and toilet water disposal system. Inspectors mark each component as clean or dirty and note any remarks. The form is signed by the inspector and acknowledged by health and safety staff.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    Toilet Inspection Form

    Doc. No. 26071-JO-HSE-023


    Effective Date 16 December 2020
    Revision No. 000

    Date / Time : Week :


    Place : Company :

    Inspection results
    No Inspection Comonents Remarks
    Clean Dirty

    1 Kloset / Closet

    2 Lantai / Floor

    3 Dinding toilet / the toilet wall

    4 Kran toilet / bathroom faucet

    5 Pintu toilet / the tollet door

    Sanitasi air pembuangan toilet / Sanitation of


    7
    toilet water disposal

    NB : (√) Done(x) Not Done

    Prepared, Acknowledged by,

    HSE SI / Medical
    team

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