Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Survey Details
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Surveyor Name:
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Survey Date:
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Client
General Site Information
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Store Name:
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Store Number:
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Store Address:
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Store Telephone Number:
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Store Opening Times:
Delivery Of Hardware
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Any Delivery Restrictions, Yes or No? If Yes Specify:
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Any Restrictions on Traffic? Yes/No. If Yes Specify:
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Any Restrictions on Parking, Yes or No? If Yes Specify:
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Location to Off Load:
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Delivery via Scissor Lift, Yes or No? If Yes Note Weight Limit:
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Photos Of Location for Delivery Vehicle To Off Load:
Special Delivery Equipment:
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Specify Special Delivery Equipment Required, i.e. pallet truck, skates etc.
Obstacles On Route to ATM Position:
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Kerb, Yes or No? If Yes Specify Height:
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Stairs Yes or No? If Yes Specify Number of Steps and Height:
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Mat Well Yes or No? If Yes Specify Size:
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Any Other Obstacles On Route To ATM Position, Yes or No? If Yes Specify:
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Photos Of Any Obstacles on Route To ATM Position:
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Ceiling Height
Doors On Route To ATM Position
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Minimum Door Size On Route To ATM Position:
Delivery Route External Floors:
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External Floor Types:
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Other:
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Delivery Route Internal Floors:
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Internal Floor Types:
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Other:
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Internal Floor Covering:
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External Detail:
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Is The Exterior Lighting Adequate In The ATM Area?
- Yes
- No
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Are CCTV Cameras Facing Proposed ATM Area?
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Are Bollards Required( 2000mm back from ATM)?
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Do External Graphics Need Relocating - Yes/No. If Yes Specify
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Are There Any Services Impeding ATM Location Yes/No If Yes Please Specify.
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Internal Detail:
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Location Of ATM:
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What Material Will The Aperture Be Going Through?
- Glass
- Composite Panel
- Brick Wall
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What Is The Thickness Of Aperture?
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Size Of Glazed Panel Where Aperture Will Go:
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Is There A Difference in External and Internal Floor Levels?
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Any Refrigeration Need Relocating, Yes or No? If Yes Specify
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Any Tills Need Relocating, Yes or No? If Yes Specify?
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Any Shelving/Gondola Need Relocating, Yes or No? If Yes Specify
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Any Other Obstacles Need Relocation? Yes or No, If Yes Specify With Possible Relocation Position.
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Any Internal Signage To be Relocated Yes or No? If Yes Specify
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Any Internal Services To Be Relocated? Yes or No. If Yes Specify.
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Aisle Width Measurement Created When Bastion Unit In Place If Applicable:
Electrical/Data Detail
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Fuse board Location
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Comms Cabinet Location
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Location Of DP
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