C6cycles Assessment

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Date / Time booked in

  Date

Contact Details

• Full Name

• Email address

• Telephone number

• Address

User Requirements

• Highlighted problems

• Requested Upgrade options

Bike Details

• Picture of Bike

  Media

• Make

• Model

• Value

Health and Safety

• Cleanliness (0=Spotless 10=Filthy)

• Sharp objects - Visual check damaged cables / frame

Bike Assessment

Drive Chain

• Chain wear (0=bad 10=good)

• Overall crank condition (0=bad 10=good)

• Rear Cassette condition (0=bad 10=good)

• Front Derailleur condition (0=bad 10=good)

• Rear Derailleur condition (0=bad 10=good)

• Bottom bracket bearings (0=bad 10=good)

Brakes

• Front brake pads wear

• Front brake cable condition

  Good

  Poor

  Immediate replacement

• Rear brake pads wear

• Rear brake cable condition

  Good

  Poor

  Immediate replacement

Wheels

• Front wheel true (0=bad 10=good)

• Front wheel spoke tension (0=bad 10=good)

• Front tyre condition (0=bad 10=good)

• Front wheel bearings (0=bad 10=good)

• Rear wheel true (0=bad 10=good)

• Rear wheel spoke tension (0=bad 10=good)

• Rear tyre condition (0=bad 10=good)

• Rear wheel bearings (0=bad 10=good)

completed

• Signed by

  Sign

• Date completed

  Date