Title Page

  • Client / Site

  • Surveyors name:

  • Site Name and UAT Number:

  • Conducted on

Site Information

Site details

  • Site name:

  • Site UAT number:

  • Site Address (in full, including postcode):
  • Site telephone number:

  • Site email address:

  • Site manager name:

  • Type of site:

  • If OTHER, insert type of site:

  • Is the site a HOST MANAGED site:

  • Does the location have any other ATM's near the Barclays ATM:

  • If YES, who are they owned by (take photograph, if possible):

Site Access Information

  • Site opening times:

  • Does the site have 24hr access:

  • Is the site manager the primary contact for site access:

  • If NO, give details of primary contact for site access including full name, contact telephone number and email address:

  • Are there tenants living above the site:

  • If YES, give full details:

  • Listed Building. Is the building listed:

  • If YES, give full details:

  • Delivery restrictions:

  • If YES, give full details:

  • Is the site within a congestion charge zone:

  • Is the site within a RED ROUTE:

  • Are there a height or weight restriction on the access route to site:

  • If YES, give full details:

  • Are they any planned road works or closures on routes leading to site that will impede replacement works :

  • If YES, give full details:

  • Parking restrictions:

  • If YES, give full details, include parking permit authority or Local Authority name:

  • Noise restrictions:

  • If YES, give full details:

  • Kerbs: Are there any kerbs on route to site:

  • If YES, give full details, including kerb height (mm). Note location to site of nearest dropped kerb:

  • Steps. Are there any steps into the site:

  • If YES, give full details, including number of flights, steps per flight, height per step (mm), depth of tread (mm) and stair construction:

  • Equipment

  • Is specialist lifting or manual handling equipment required in support of ATM delivery:

  • If YES, give full details:

  • Is other special equipment required in support of ATM delivery:

  • If YES, give full details:

  • Pavement Protection. Is pavement protection required:

  • If YES, give full details of why and where the pavement protection is required:

Summary

  • Has the site manager been advised of the ATM delivery requirements:

  • Unloading/Loading Area Summary. Give summary of unloading/loading area, including pedestrian control measures required, distance from site entrance and site trading peak times:

  • Photographs on Unloading/Loading Area. Show images of unloading/loading area, route from unloading/loading area to site entrance including surface type, camber, any obstacles shown above and in this section.

Route to ATM Housing

  • Mat Well. Is there a mat well:

  • If YES, give full details:

  • Internal floor construction type along ATM delivery path:

  • Internal floor quality. Does the internal floor have the load bearing capacity to carry the ATM during transit:

  • If NO, give full details, including if further examination is required:

  • Basement/Cellar. Is there a basement/cellar that may effect the ATM replacements works:

  • If YES, give full details:

Doors and Doorways

  • List internal door and doorway widths, at their narrowest point when fully open, along ATM delivery path:

  • Door 1. Type and width (mm):

  • Doorway 1. Width (mm):

  • Door 2. Type and width (mm):

  • Doorway 2. Width (mm):

  • Door 3. Type and width (mm):

  • Doorway 3. Width (mm):

Route Obstacles

  • Steps. Are there any steps along ATM delivery path:

  • If YES, give full details, including number of flights, steps per flight, height per step (mm), depth of tread (mm) and stair construction:

  • Route Clearance. Are there any obstacles along ATM delivery path that need to be relocated prior to the delivery of the ATM:

  • If YES, give full details, taking note of refrigeration units, tills and self-scan units, shelving and gondolas, internal signage and services and merchandising:

ATM Housing

  • ATM housing type:

  • If OTHER, give full details:

  • ATM door housing type and dimensions (mm), including width at narrowest point when fully open and height:

  • ATM door keys (quantity) and lock type:

Equipment

  • Floor Protection. Is floor protection required along the ATM delivery path:

  • If YES, give full details, including why and where the floor protection is to be used:

  • Is specialist lifting or manual handling equipment required in support of ATM delivery:

  • If YES, give full details:

  • Is other special equipment required in support of replacement works:

  • If YES, give full details:

Summary

  • Route to ATM Housing Summary. Give description of route the ATM is to take on site including approximate distance and number of turns to ATM housing access point:

  • Has the site manager been advised of the ATM delivery requirements along the ATM delivery path within the site:

  • Photographs of ATM Path. Show images of the route the ATM will take including the areas of concern shown above and in this section:

ATM Housing

ATM Housing. Construction information.

  • Any non - domestic property that was built before 2000 (asbestos was banned in the UK in August 1999) is to have an Asbestos Register or Survey available on request to show whether there are Asbestos Containing Materials (ACMs) used in the construction of the building in the area around the ATM; specifically the floor on which the ATM will sit, the wall where the ATM will pass and areas in the building where works maybe carried out in support of the ATM works that may disturb ACMs. Any non – domestic property constructed after 2000 does not require an Asbestos Register or Survey. A copy of the site Asbestos Register or Survey is to be taken at the time of ATM Transport Survey for future reference.

  • Asbestos Register or Survey. Is there an Asbestos Register or Survey for the ATM housing:

  • If YES, give full details.

  • If NO, was the building constructed prior to 2000, if so, an Asbestos Survey or Register MUST BE LOCATED.

  • CAT Scan. Has a CAT scan of the area around the ATM been completed:

  • Give full details of scan and any findings:

  • ATM housing floor construction type:

  • Has a test hole been drilled in the floor:

  • Give full details on test hole:

  • Aperture wall construction type:

  • If OTHER, give full details:

  • Does the ATM housing have air conditioning:

ATM Housing. Access, telephone ports, electrical supply and alarm information.

  • Is a BAU Engineer required to gain access to the ATM housing:

  • If NO, give full details of ATM housing key holder:

  • ATM housing alarm type:

  • If OTHER, give full details:

  • ATM housing alarm contractor name:

  • Number of telephone ports in ATM housing:

  • Give details of telephone ports, including how many are being used:

  • Number of 13A sockets in ATM housing:

  • Give details of 13A sockets, including how many are being used:

  • Number of lights in ATM housing:

Existing ATM Details:

ATM 1.

  • ATM serial number:

  • ATM type:

  • Plinth height (mm):

  • Alarm fitted:

  • Chains fitted:

  • Internal scar plate fitted:

  • Location of ATM router:

  • ATM Power supply type:

  • Are there any obstructions above the aperture or ATM:

  • If YES, give full detail:

  • Power supply for external ATM lighting:

  • Is there any damage to the existing ATM:

  • If YES, give full detail:

ATM 2.

  • ATM serial number:

  • ATM type:

  • Plinth height (mm):

  • Alarm fitted:

  • Chains fitted:

  • Internal scar plate fitted:

  • Location of ATM router:

  • ATM Power supply type:

  • Are there any obstructions above the aperture or ATM:

  • If YES, give full detail:

  • Power supply for external ATM lighting:

  • Is there any damage to the existing ATM:

  • If YES, give full detail:

ATM Housing. Internal Services.

  • Internal services that require removing or relocating:

  • If YES, give full details, including utility services that require relocating, stock that needs to be relocated prior to works and any other obstacles that may impede the replacement works within the ATM housing:

Summary

  • Has the site manager been advised of the ATM replacement works requirements:

  • ATM Housing Summary. Give description of the ATM housing, concerns and further requirements in support of replacement works:

  • Photographs of ATM Housing. Show images of the ATM housing including the existing ATM's, plinths, power supplies and fuse boards, routers, alarms, chains and apertures:

Deployment Complexity Indicator

  • GREEN - straight ATM swap, with no site issues or additional costs.<br>AMBER - additional works required that may increase installation time and complexity.<br>RED - Any complex works, including structural or construction works, listed building application or landlord consent, to proceed and get the ATM in position.

External ATM Features

Existing ATM Details.

ATM 1.

  • Pavement construction type:

  • Is the ATM covered by CCTV:

  • ATM Canopy. Is there a canopy covering the ATM:

  • Will external signage need to be relocated:

  • If YES, give full details:

  • External scar plate fitted:

  • Key 5 height (mm):

  • Footprints. Does the ATM have footprints:

  • Bollards. Does the ATM have bollards:

  • Does the bezel require a silicone seal applying:

  • Photographs of ATM 1. Show images of ATM including 'close-ups' of the bezel and signage, 'distance' images of the site including the existing ATM and of the parts detailed in this section:

ATM 2.

  • Pavement construction type:

  • Is the ATM covered by CCTV:

  • ATM Canopy. Is there a canopy covering the ATM:

  • Will external signage need to be relocated:

  • If YES, give full details:

  • Key 5 height (mm):

  • Footprints. Does the ATM have footprints:

  • Bollards. Does the ATM have bollards:

  • Does the bezel require a silicone seal applying:

  • Photographs of ATM 2. Show images of ATM including 'close-ups' of the bezel and signage, 'distance' images of the site including the existing ATM and of the parts detailed in this section:

Summary

  • Has the site manager been advised of the external ATM replacement works requirements:

  • External ATM Features Summary. Give description of the external ATM features, concerns and further requirements in support of replacement works:

  • Please Take all external Dimensions for proposed new signage.

DISCLAIMER: NCR IS NOT RESPONSABLE OR LIABLE FOR THIRD PARTY PRODUCTS MANUFACTURED USING THESE DETAILS FOR EXTERNAL SIGNAGE

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.