Range Value Lookup Checklist
Record and verify measured values against specified acceptable ranges for each checklist item.
Checklist Reference ID
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector Full Name
*
First Name
Last Name
Department/Area
*
Please Select
Production
Quality Control
Maintenance
Warehouse
Other
Checklist Items and Measured Values
*
Rows
Item/Parameter
Measured Value
Min Acceptable
Max Acceptable
Status
Item 1
In Range
Out of Range
Not Applicable
Item 2
In Range
Out of Range
Not Applicable
Item 3
In Range
Out of Range
Not Applicable
Item 4
In Range
Out of Range
Not Applicable
Item 5
In Range
Out of Range
Not Applicable
Were all measured values within the acceptable range?
*
Yes, all within range
No, at least one out of range
If any value was out of range, was corrective action taken?
*
Yes
No
Not Applicable
Details of Corrective Action (if applicable)
General Comments or Observations
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