Cleanroom Monitoring Checklist Form
Document routine cleanroom inspections with this checklist for compliance and operational quality.
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspection Time
*
Hour Minutes
AM
PM
AM/PM Option
Inspector Name
*
First Name
Last Name
Facility or Department
*
Please Select
Pharmaceutical Production
Research Laboratory
Medical Device Manufacturing
Electronics Cleanroom
Other
Cleanroom Location/Area
*
Environmental Condition Check
*
Rows
Pass
Fail
N/A
Temperature
1
2
3
Humidity
4
5
6
Air Pressure
7
8
9
Airflow
10
11
12
HEPA Filter Status
13
14
15
Contamination/Particulate Observations
*
No visible contamination
Minor particulate detected
Major contamination present
Equipment/Status Checks
*
Equipment operational
Calibration up to date
Supplies stocked
Protective gear available
Other (specify in notes)
Corrective Action or Issue Notes
Overall Status
*
Pass
Fail
Conditional Pass (see notes)
Additional Comments
Submit Checklist
Should be Empty: