Title Page

  • Conducted on

  • Completed By

  • Site

  • Customer Contact name

  • Customer Phone Number

  • Customer Email Address

  • Quote Required By

  • Site Induction Details

  • Risk & Method Statement Required

Automatic Gates

  • Automatic Gate Survey

  • Gate Survey - Complete from the inside of the property looking out to the road.

  • Gate Location

  • Type of System Required

  • Removal of old system required?

  • Width of entrance Post to Post on inside (mm)

  • Maximum width available (mm)

  • Opening Angle (Degrees)

  • Gate leaf to obstacle distance Crushing (mm)

  • Post width (mm)

  • Post Depth (mm)

  • Post Height - Ground level to top of post (mm)

  • Post Replacement Required?

  • Hinge center to corner

  • Hinge center to face of post

  • Hinge gap between post and leaf

  • Length of Leaf R/H

  • Length of Leaf L/H

  • Height of Leaf R/H

  • Height of Leaf L/H

  • Hinge Kit Required

  • Gate Leaf(s) Required

  • Distance from bottom of gate to floor

  • Distance from bottom of gate to floor when fully open

  • Ground level type

  • Type of operator(s) required

  • Opening Stops Required

  • Closing Stops Required

  • Infill Type

  • Supply voltage present

  • Mains isolation kit required?

  • Battery back-up Kit

Activation & Locking

  • Transmitter Fobs & Qty

  • Ground Exit Loop & Size

  • Keypad

  • keypad Post & Size

  • Exit Button

  • Intercom & Type

  • Lock Required & Type

Safety

  • Outer Photocells Required

  • Inner Photocells Required

  • Battery Photocell

  • Safety Loop & Size, and Detector Type

  • Safety Edge - Hinge Gap Profile & Length

  • Safety Edge - Leaf to Leaf Closing Profile & Length

  • Safety Edge - Opening Lower Profile & Length

  • Safety Edge - Closing Lower Profile & Length

  • Wireless Safety Transmitters Required & Receiver

  • Laser Scanner & Bracket Required

  • Stop Button

  • Flashing Beacon

Cable Requirements

  • 12 core Duct Grade - Accessories (Distance in M)

  • Mains Flex Cable 3core*0.75mm (Distance in M)

  • Intercom Cable (Distance in M)

  • Motor cable 5core*0.75 (Distance in M)

  • Underground Ducting Size & M

  • Mains 240V Supply Armour Cable (Distance in M)

Additional

  • Conduit in (M) & Colour

  • Copex in (M) & Colour

  • Post Crete Bags (Qty)

  • IP Joint Boxes

  • Glands & Saddles

Fixings Required

  • Coach Bolts (Size & Qty)

  • Chemical Resin (Qty)

  • Anchor Bolts (Size & Qty)

  • Tech Screws

  • General Fixings Screws

Other

  • Photos

  • Describe any additional information not listed

Automatic Doors

  • Autodoor Survey

  • Site location/ Equipment Reference Number

  • List equipment already installed

  • Photo of door

  • Door width (mm)

  • Door height (mm)

  • Header Height

  • Header Width

  • Revil depth

  • Door operator backing plate required?

  • Door type

  • Arm required

  • Safety Sensor Required & Size

  • Flat Scan Sensor

  • Hinge guard required

  • Pedestrian Barrier (900mm) required

  • Door lock, Type & Voltage

  • Relays

  • Images of lock/ area

  • Additional lock details for on site equipment

  • C-PROX or other fobs remote required

  • Push button (Wired or Wireless)

  • Key switch required

  • Existing Mains Power Supply - Switch Fused Spur - Required

  • Safety Signage

  • Additional Cable & Cable protection required

  • Operator Fixings Required

  • Safety Glass Installed or Required

  • Emergency Escape - Break glass

  • Battery Back up

  • Fire Alarm connection

  • Detail any additional customer information or requests that's required for the quote.

  • Photos

Automatic Barriers

  • Barrier Survey

  • Foundation Width

  • Foundation Length

  • Foundation Depth

  • Additional Concrete Bases

  • Kerb to Kerb width (Road crossing)

  • Catch post required

  • Pogo stick required

  • Skirt required

  • Foundation Bolts (M12 Required)

  • Chemical Resin required

  • Pedestrian Railing required

  • Boom Length Required

Accessories

  • Keypad

  • Keypad power supply

  • Magnetic Lock

  • Magnetic Lock brackets

  • Lock Relay

  • Top light

  • Boom strobe light

  • Traffic light & mounting bracket

  • Photocell

  • Photocell batteries

  • Safety loop & size

  • Free Exit loop and size

  • Entrance loop and size

  • Loop detector, voltage and type.

  • Battery back-up kit

  • Access Control other

  • Access control posts

Cabling

  • Ducting & length required

  • Describe ground trenting works

  • 12 core duct grade cable (in M)

  • 3 core mains flex cable (in M)

  • Other cable required

  • Copex, Conduit & cable protection required

  • Mains switch spur (located internally)

  • External rotary isolator

Additional

  • Manual over ride keys (Qty)

  • Master lock site key safe

  • Timer Switch

  • Safety Signage

  • Describe any additional details required

  • Site photos

  • A Traffic Barrier survey has not been completed

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.