Title Page
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Store Number
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Store Name
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Date Of Visit
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Branch
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Engineer Name
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Request Number
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Work Order Number
Condemnation Form
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Gas Type
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Fabric Condition
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Asset/Equipment Type
- Case
- Backup Chiller
- Pharmacy Fridge
- A/C
- Cold Room
- Refrigeration Pack
- Condensing Unit
- AHU
- Water Chiller
- Spiral Chiller
- Blast Chiller
- Spiral Freezer
- Blast Chiller
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Remote/Integral?
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Electrical Supply
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If 'Other' please provide details
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Refrigeration Alarm
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Make & Model
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Size
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Asset Tag Number
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Details of Fault/Reason for Condemnation
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Access to store for replacement (Doors, railings, bollards, PIR, steps to store, street access, nearest car park for 12t Lorry etc)
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Does the Cabinet have doors?
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If Yes please specify Door Size and Frame Size
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Engineers General Condition Comments
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Managers General Comments
Equipment Photographs
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Fig 9
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Fig 11
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Fig 12
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Fig 12: