Cleaning Method Statement Form
Document and approve cleaning procedures, responsibilities, and safety measures for your project or site.
Project or Site Name
*
Location/Area to be Cleaned
*
Date of Cleaning
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Description of Cleaning Task
*
Cleaning Methods to be Used
*
Manual cleaning
Wet cleaning
Dry cleaning
Disinfection
Vacuuming
Other
Equipment and Materials Required
*
Personal Protective Equipment (PPE) Required
Gloves
Safety goggles
Face mask
Protective clothing
Other
Potential Hazards and Risk Controls
*
Person Responsible for Cleaning
*
First Name
Last Name
Supervisor/Approver Name
*
First Name
Last Name
Supervisor/Approver Email
*
example@example.com
Additional Notes or Comments
Supervisor/Approver Signature
*
Submit Method Statement
Submit Method Statement
Should be Empty: