Title Page

  • Store Number

  • Store Name

  • Date Of Visit

  • Branch
  • Engineer Name

  • Request Number

  • Work Order Number

Condemnation Form

  • Age

  • Gas Type

  • Calls in last year

  • Fabric Condition

  • Asset/Equipment Type

  • Remote/Integral?

  • Electrical Supply

  • If 'Other' please provide details

  • Refrigeration Alarm

  • Make & Model

  • Size

  • Asset Tag Number

  • Details of Fault/Reason for Condemnation

  • Access to store for replacement (Doors, railings, bollards, PIR, steps to store, street access, nearest car park for 12t Lorry etc)

  • Does the Cabinet have doors?

  • If Yes please specify Door Size and Frame Size

  • Engineers General Condition Comments

  • Managers General Comments

Equipment Photographs

  • Fig 1

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  • Fig 12

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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.