Asset Information

Asset Information


Control PCB


Barrier Setup

Arm Length (in M)

Road Width (in M)

Tip Rest Type?

Keys Switch Override

Maintenance Label Installed?

Is CE label installed


General Condition




Smoothness of Operation?

Cables connection and loops condition?

KeySwitch Operation

Entry Devices

Access Control

Audio Entry

Remote Fixed Button

Remote RX Fobs

Entry Loop

Size of loop

Entry Type Other

Other Entry Type

Exit Devices

Access Control

Audio Entry

Remote Fixed Button

Remote RX Fobs

Exit Loop

Size of loop

Exit Type Other

Other Entry Type


Mains Power & Fire

LocalPower Isolation?

Power isolation outside barrier?

Is battery support installed?

Fire alarm relays installed

It is not clear to us whether a fire interface has been installed for this barrier, therefore if barrier requires fire alarm interface Client is advised to check this with their appointed fire advisor, and check during regular fire alarm test as to whether this barrier does respond in a suitable way. Fire alarm interfacing and programming can be retrospectively carried out. Further information available on request.

Has it been tested


Safety Devices

Safety Device Fitted?

Vehicle Photo Cells

Dual Height Vehicle Photo Cells

Vehicle Safety loop

Stop Signage

Vehicle Safety Signage

Arm Illumination

Pedestrian Safety Fitted?

Pedestrian Photo Cells

Bumper Strip

InMotion Sounder Alert

InMotion Light Alert

Pedestrian Safety Signage

Adequate illumination

Pedestrian Separation

Other Safety Devices

Safety Railing(s) installed?

Other safety Items not listed


Have any Hazards been identified?


Hazard Type

Risk Level

Action by:


Add media


Additional Recommendations


Action by:

Risk Level


Add media

Summary PMI Outcome

Audit/Assessment Findings

Based on the above assessment we consider this system to have:

Congratulations your system has PASSED its visual Safety Audit/Assessment. and subject to suitable preventative maintenance and Impact testing is considered at his time to be safe to operate.
Please ensure though you carry our regular visual checks and ensure any actions needed are reported immediately to us.

Your system is considered to have PASSED with ADVISORIES its visual Safety Audit/Assessment, however we have identified minor recommendations or remedial works required, but that do not significantly impact on the safe use of the barrier. Additional remedial works will be provided to you in a separate report along with associated costs for your action as soon as possible

Your system is considered to have FAILED it's visual Safety Audit/Assessment on at least one serious items that we consider has a significant impact on the safe use of the system and in our opinion is may not comply with current HSE guidelines and British and European Standards. Remedial Action identified and risk levels will be provided along with associated costs for you to authorise.

In the meantime you may wish to consider placing the system "out of action"until these remedial works are completed!

Your system has been CONDEMNED which indicates that we have noted significant failures in either the structure which could lead to injury, lack of adequate safety devices or failures in system operation that render the system unsafe and potentially dangerous for use..

We strongly advise the system be placed "out of action" until such time as immediate remedial or replacement works can be carried out.

Engineer signature
Client signature (where applicable)
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.