Designated Smoking Area Checklist Form
Use this checklist to document the inspection status, observations, and follow-up actions for a designated smoking area.
Smoking area clearly marked with appropriate signage
*
Signage is visible and legible
Area free from combustible materials
*
No flammable items within 3 meters
Adequate ashtrays or disposal bins provided
*
Ashtrays/bins available and in good condition
Disposal bins emptied regularly
*
Bins are not overflowing
Smoking area is clean and free of litter
*
No cigarette butts or trash present
Shelter or cover provided (if required)
*
Shelter is present and in good condition
Adequate ventilation in the smoking area
*
Area is well-ventilated
No evidence of smoking outside the designated area
*
No cigarette butts or litter outside the area
Observations or issues noted during inspection
Issues observed (specify below)
Follow-up actions required
Action needed (specify below)
Submit Inspection
Should be Empty: