TEMPLATE · NOT A COMPLETION CERTIFICATE
Sample report structure
Complete all values from actual work records. This sample does not certify cleaning, disinfection or measurements.
1. Basis and agreed scope
Complete using actual facility data
2. Facility, system identifiers and section boundaries
Complete using actual facility data
3. Initial condition and identified limitations
Complete using actual facility data
4. Method, equipment and operations actually completed
Complete using actual facility data
5. Verification: method, conditions and actual readings
Complete using actual facility data
6. Photos/video if agreed with the client
Complete using actual facility data
7. Disinfection and laboratory protocols where included
Complete using actual facility data
8. Outstanding issues and recommendations
Complete using actual facility data
9. Appendices, date, responsible persons and acceptance
Complete using actual facility data
