Sop checklist
Standard operating procedure template
What does this form include?
This form contains 58 sections:
Work Areas Affected
Detailed Location Information - Specific Information of areas impacted. Room Numbers, Floor Numbers, etc.
Select All Affected Systems
Is Equipment Being Affected?
Equipment I.D.
Equipment Manufacturer
Equipment Model Number
Equipment Serial Number
Equipment Photo
Determine the Technical position needed to perform this work
Select Position / Trade
Skill Level Requirement
Define Responsibilities of this position
Determine the Management / Leadership Position staff required to perform this work
Select Management / Leadership Position
Define Other Management / Leadership Position
Determine Additional Support Positions
Select Additional Support Position
- Select Additional Support Position
Provide an overview of the work to be performed, estimate of time to complete, and summarize expected
Scope of Work - Overview of the Work to Be Performed. What are we doing?
Purpose of Work - Why are we doing the work?
Goal - What is the expected result?
Detail of Impacted Facility Systems
Main Utility Equipment
- Main Utility Equipment
- Emergency Generator System
- Cooling System
- Heating System
- Fire Monitoring System
- Fire Detection System
- Fire Suppression System
- BMS - Building Management System
- Security System
- General Power and Lighting Systems
- LOTO (Lock-out / Tag-out) Required?
Add Photo of the LOTO Item
Identify all documents required to support successful completion of this work. Example: OEM manual, s
All personnel involved in the procedure have read and agree to adhere to the SLAC “Worker Safety and Health Program.
- All personnel involved in the procedure have read and agree to adhere to the SLAC “Worker Safety and Health Program.
Are there potential hazards?
- Are there potential hazards?
Personnel Protective Equipment (PPE) required. Check all that apply
Refer to Site Specific Facility Operations Manual (FOM) Maintenance Management Plan (MMP) Risk sectio
Identify each risk and contingency plan.
Risk 1 RAC (Risk Assessment Code)
- Risk 1 RAC (Risk Assessment Code)
Risk Details
Specific to the risk noted above, what is the plan to deal with the risk should it come to be realize
Contingency Plan for Risk
Supporting Photos
Name of Person to be Notified
Title of person to be Notified
Email of person to be notified.
Mobile Phone Number of person to be notified.
List the very specific steps that will be taken to complete this work. This should include every acti
Step Detail
Include any photos to help demonstrate this step.
Date and Time this step was completed Date
Initials of person performing the work
Dry Run Performed (Physical Walkthrough) Note: Vendor needs to be involved in walkthrough with FM TEC
Management Representative Approval
Management Representative Name and Title
Management Representative Signature
Date of Management Representative signature Date
Date of Management Representative signature
Technical Representative Approval
Technical Representative Name and Title
Technical Representative Signature
Date of Technical Representative Signature Date
Date of Technical Representative Signature
Day of work instructions and Notes/Findings:
Use this template