Glass and Brittle Plastic Inspection Checklist Form
Use this checklist to document the inspection of glass and brittle plastic items. All findings and actions should be recorded accurately. Title is consistent across all descriptions.
Date of Inspection
*
-
Month
-
Day
Year
Date
Location of Inspection
*
Item Identification or Reference
*
Type of Item
*
Please Select
Glass
Brittle Plastic
Other
Checklist: Defects Observed (select all that apply)
Cracks
Chips
Scratches
Discoloration
Contamination
Other (please specify below)
If 'Other' defect observed, please specify
Condition of Item (select all that apply)
*
Intact
Damaged
Requires Cleaning
Needs Replacement
Risk Level
*
Low
Moderate
High
Required Action(s) (select all that apply)
*
No Action Needed
Clean Item
Repair Item
Replace Item
Remove from Service
Inspector Name
*
Submit Inspection
Should be Empty: