Information

  • Quote No.

  • Survey Title (site name then title)

  • Client

  • Conducted on

  • Prepared by

  • Location / site

A/C splits

A/C system

    A/C system
  • FCU Location / Area served

  • Picture ?

  • Manufacturer

  • FCU style

  • Model number

  • Serial number

  • Controller

  • Model number

  • Condensate removal

  • Condenser Location / Area served

  • Picture ?

  • Condenser style

  • Model number

  • Serial number

  • Refrigerant

  • Quantity (kg)

  • Notes

Chillers

Chillers

    Chiller
  • Chiller Location / Area served

  • Picture ?

  • Manufacturer

  • Chiller type

  • Chiller style

  • Model number

  • Serial number

  • Refrigerant

  • Quantity (kg)

  • Notes

Multi split

Multi splits

    Fan coil unit
  • FCU Location / Area served

  • Picture ?

  • Manufacturer

  • FCU style

  • Model number

  • Serial number

  • Controller

  • Model number

  • Connected to joint or BS box etc

  • Model number

  • Condensate removal

Condenser

  • Condenser Location / Area served

  • Picture ?

  • Refrigerant

  • Quantity (kg)

  • Notes

VRV/VRF systems

VRV / VRF system

  • VRV / VRF system

  • VRV / VRF system Fan coil unit
  • FCU Location / Area served

  • Picture ?

  • Manufacturer

  • FCU style

  • Model number

  • Serial number

  • Controller

  • Model number

  • Connected to joint or BS box etc

  • Model number

  • Condensate removal

  • Condenser Location / Area served

  • Picture ?

  • Refrigerant

  • Quantity (kg)

  • Controller Location

  • Controls style

  • Picture ?

  • Notes

Close control units

Close control units

    Chilled water unit
  • Unit Location / Area served

  • Picture ?

  • Manufacturer

  • Unit style

  • Model number

  • Serial number

  • Condensate removal

  • DX unit

  • DX unit
  • Unit Location / Area served

  • Picture ?

  • Manufacturer

  • Unit style

  • Model number

  • Serial number

  • Condensate removal

Condenser

    Condenser
  • Condenser Location / Area served

  • Picture ?

  • Refrigerant

  • Quantity (kg)

Pumps

Pumps

    Pump
  • Pump location

  • Picture ?

  • Select medium

  • Manufacturer

  • Pump style

  • Model number

  • Serial number

Boilers

Boilers

    Forced draught Boiler
  • Boiler location

  • Picture ?

  • Manufacturer

  • Model number

  • Serial number

  • Select fuel

  • Boiler type

  • Burner
  • Manufacturer

  • Picture ?

  • Model number

  • Serial number

Pressurisation units

Pressurisation units

    Pressure set
  • Serving?

  • Picture

  • Model

  • Serial

Booster sets

Booster set

    Booster set
  • Serving?

  • Picture

  • Model

  • Serial

Supply fans

Supply fan

    Supply fan
  • Serving?

  • Picture

  • Model

  • Serial

Extract fans

Extract fan

    Extract fan
  • Serving?

  • Picture

  • Model

  • Serial

Air handling units

Air Handling Unit

    Air Handling Unit
  • Serving?

  • Picture

  • Model

  • Serial

Cooling towers

Cooling Tower

    Cooling Tower
  • Serving?

  • Picture

  • Model

  • Serial

CWS Tank

CWS Tank

    CWS Tank
  • Serving?

  • Picture

  • Model

  • Serial

  • Size L x W x H

  • Capacity

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.