REMOVAL OF FACTORY PLANT & EQUIPMENT CHECKLISTDate Equipment To Be Removed:- ( )

SCOPE All equipment which is to be removed from operation and/or the factory environment

PURPOSETo ensure that all equipment is removed from operation/the factory in such a way as to minimise the risk to food safety and to ensure the factory planned maintenance scheme is updated to record the equipment’s removal.

Part A: - DESCRIPTION OF WORK TO BE CARRIED OUTArea & Equipment:-

Overview of the work to be carried out:-

Part B:- PRE REMOVAL PROCEDURE Y N N/A Initial1. Engineering Handover Sheet (ref. F3 3.5 F01 L4) has been completed and placed

into the document pick up tray for hygiene. 2. Before any activity is undertaken the Senior Production, Hygiene & QA Mgr. must be

notified by email of the work being undertaken to remove/disconnect equipment as described in Part A.

3. Has production/hygiene removed all gross debris from the equipment? 4. Has all reasonably practicable precautions taken place to minimise the risk to food

safety to operations adjacent to the engineering work area. 5. Are there any cutting, grinding or welding activities to be carried out? (Note as per

the procedure these cannot be carried out during production hours)

Part C:- REMOVAL PROCEDURE Y N N/A Initial6. Electrical supply (where applicable) has been isolated and locked off to prevent the

supply being accidentally switched on. 7. Compressed air supply has been isolated and locked off to prevent the supply being

accidentally turned on. 8. Production staff adjacent to the work area has been notified of the work being carried

out. 9. Magnetic trays or clearly identified containers are available to collect and contain any

fastener or fitting removed. 10. On completion of the removal operation, has the area been cleaned of all debris such

that there are no risks to food safety on adjacent operations? 11. All cables/pipes have been coiled up and secured safely as to eliminate any

food/personal safety.

12. All tools have been removed from the area. 13. ENGINEER CONFIRMS EQUIPMENT HAS BEEN TAKEN OUT OF SERVICE.

Part D:- POST REMOVAL PROCEDURE14.This is to confirm that the equipment has been removed from the Planned Maintenance system

following the planned removal of the equipment and is no longer in operation. No removal can be made without the authorisation of the Engineering Manager.

Print Name:-

Signature:- Date equipment removed from PM System:-

Reference Number Issue Number Issue Date Page Issued By02 15/03/12 1 of 1