Title Page

  • Survey Number (Auto Generated)

  • Prepared by

  • Site Name

  • Conducted on

  • Location
  • Template Version 02 - 04/08/22

Initial Site Details

  • Store Frontage Photo (Photo)

  • Confirm you have signed in with store (Photo)

  • Customer Project

  • Other selected, define Project

  • Brief Scope of Works

  • Site-Specific arrangements (Parking Registration, Pay & Display, Part of Shopping Centre)

  • Quantity of New Cases (Detail to be input later in survey)

  • Quantity of Cases being Removed (Detail to be input later in survey)

  • Quantity of Cases Relocating (Detail to be input later in survey)

New Cabinets

    New Cases (Add new for each run of cases being removed)
  • Case Numbers (if known) & Type

  • Supplier and Model Names

  • Remote or Integral

  • Refrigerant

  • Proposed Location (Markup Drawing & Photo)

Services

Refrigeration Services

  • Cabinet Refrig Services - Top or Bottom Entry

  • Description of Route (Pack, Service route including bends and wall penetrations, etc)

  • Pipe Sizes

  • Ball Valve Location

  • Ball Valve Location (Photo & Markup)

  • Approx route length (metres)

  • Photos & Markup of Route (Include any proposed service T locations)

  • Containment Required? (Pearling clips, window brackets etc?)

  • Other relevant existing Services Photos / Markups

Electrical Services (See Previous Section for Shop Services DB Details)

  • Cabinet Electrical Services - Top or Bottom Entry

  • Description of Cable Route (including wall penetrations etc)

  • Local Distribution Board Identification including location in the store

  • Photo of existing Local DB schedule

  • Available spare ways on board?

  • DB Supply cable type and size?

  • Approx route length to case (metres)

  • Photos & markup of Route

  • Containment Required? (Pearling clips, window brackets etc?)

  • Other relevant existing Services Photos / Markups

Drainage Services

  • Description of requirements, Location, Type and pipe size

  • Drainage Type (Pumped or Gravity?)

  • Approx route length (metres)

  • Photos /Markup of Route

  • Containment Required? (Pearling clips, window brackets etc?)

  • Other relevant existing Services Photos

Data Services

  • Type - IP or Serial (RS485)

  • Description of Route, nearest HUB location, spare ports

  • Approx route length (metres)

  • Colour of cables used onsite

  • Photos & markup of Route

  • Containment Required? (Pearling clips, window brackets etc?)

  • Other relevant existing Services Photos

  • Works to Service Columns required? (Round or Square)

  • Works to Service Columns required? (Cutting, Repairing, Relocations)

  • Round or Square?

  • Location

  • Photo

  • Is Cold Air Retrieval in Use?

  • Any Builders Works Required?

  • Any Under floor contaiment required

  • List Materials Required for new case?

  • Other relevant existing Services Photos/Markups

  • Other Relevant New Case Notes

Cabinet Removals

    Removals (Select 'Add New' for each run of cases being removed)
  • Case Numbers & Types to be Removed

  • Supplier and Model Names

  • Case Serial Numbers

  • Case Photos

  • Serial Plate Photos

  • Refrigerant

  • Remote or Integral?

Services

Refrigeration Services

  • Cabinet Refrigeration Services - Top or Bottom Entry

  • Description of Services to be cut back (Pack,route including wall penetrations, pipe sizes etc)

  • Ball Valve Location

  • Ball Valve Location (Photo & Markup)

  • Approx route length to be removed (metres)

  • Photos & Markup of Route

  • Any Containment works Required? Removal and Installation?

  • Other relevant existing Services Photos / Markups

Electrical Services (See Previous Section for Shop Services DB Details)

  • Cabinet Electrical Services - Top or Bottom Entry

  • Description of Services to be cut back (Including wall penetrations, breakers or DB's to be removed, etc?)

  • Local Supply Distribution Board Identification including location in the store

  • Photo of existing Local DB schedule

  • Approx route length to case to be removed (metres)

  • Photos & Markup of Route

  • Any Containment works Required? Removal and Installation?

  • Other relevant existing Electrical Photos / Markups

Drainage Services

  • Description of Existing drainage? Location, Type and pipe size

  • Drainage Type (Pumped or Gravity?)

  • Approx route length to be removed (metres)

  • Photos & Markup of Route

  • Any Containment works Required? Removal and Installation?

  • Other relevant existing Drainage Photos / Markups

Data Services

  • Type - IP or Serial (RS485)

  • Description of new data cable route, (nearest HUB location, spare ports, etc)

  • Approx route length (metres)

  • Colour of cables used onsite

  • Photos & Markup of Route

  • Any Containment works Required? Removal and Installation?

  • Other relevant existing Data Photos / Markups

  • Works to Service Columns required? (Round or Square)

  • Works to Service Columns required? (Cutting, Repairing, Relocations)

  • Round or Square?

  • Location

  • Photo

  • Is Cold Air Retrieval in Use?

  • Any Builders Works Required?

  • Any Under floor contaiment required

  • List Materials Required for the removal of case?

  • Other relevant existing Services Photos/Markups

  • Other Relevant Case Removal Notes

Cabinet Relocations

Case Relocations (Add new for each run of cases being relocated)

  • Case Number & Type to be Relocated

  • Supplier and Model Names

  • Case Serial Numbers

  • Case Photos

  • Serial Plate Photos

  • Refrigerant

  • Remote or Integral?

Services

Refrigeration Services

  • Cabinet Refrigeration Services - Top or Bottom Entry

  • Description of Services to be relocated (Pack, route including wall penetrations, etc)

  • Pipe sizes

  • Existing Ball Valve Location

  • Existing Ball Valve Location (Photo & Markup)

  • Approx route length to be removed (metres)

  • Approx route length to be added (metres)

  • Photos & markup of Routes (Existing and New)

  • Any Containment works Required? Removal and Installation?

  • Other relevant existing Services Photos / Markups

Electrical Services (See Next Section for Main BOH Shop Services DB Details)

  • Cabinet Electrical Services - Top or Bottom Entry

  • Description of Services to be relocated (Including wall penetrations, breakers or DB's to be (re)moved, etc?)

  • Local Supply Distribution Board Identification including location in the store

  • Photo of existing Local DB schedule

  • Approx route length to the case to be removed (metres)

  • Approx route length to be added (metres)

  • Photos & Markup of Routes (Existing and New)

  • Any Containment works Required? Removal and Installation?

  • Other relevant existing Electrical Photos / Markups

Drainage Services

  • Description of Existing drainage? Location, Type and pipe size

  • Description of New drainage arrangement? Location, Type and pipe size

  • Drainage Type in Existing Location (Pumped or Gravity?)

  • Drainage Type in New Location (Pumped or Gravity?)

  • Approx route length to be removed (metres)

  • Approx route length to be added (metres)

  • Photos & Markup of Routes (Existing and New)

  • Any Containment works Required? Removal and Installation?

  • Other relevant existing Drainage Photos / Markups

Data Services

  • Type - IP or Serial (RS485)

  • Description of the existing data cable route.

  • Description of new data cable route (nearest HUB location, spare ports, etc)

  • Approx route length to be removed (metres)

  • Approx route length to be added (metres)

  • Colour of cables used onsite

  • Photos & Markup of Routes (Existing and New)

  • Any Containment works Required? Removal and Installation?

  • Other relevant existing Data Photos / Markups

  • Works to Service Columns required? (Round or Square)

  • Works to Service Columns required? (Cutting, Repairing, Relocations)

  • Round or Square?

  • Location

  • Photo

  • Is Cold Air Retrieval in Use?

  • Any Builders Works Required?

  • Any Under floor contaiment required

  • List Materials Required for the removal of case?

  • Other relevant existing Services Photos/Markups

  • Other Relevant Case Removal Notes

Further Site-Specific Detail

  • Store Ceiling Type / Heights (Suspended Ceiling or Open?)

  • Will a Scissor Lift be required? Type? Height?

  • Restricted area details, Keys location/numbers for Roof, plant rooms etc

Warehouse Details

  • Identify Refrigeration Shop Services Distribution board locations (Comments)

  • Identify Refrigeration Shop Services Distribution board locations (Photographs)

  • Distribution Board Schedules/Circuit information within the boards? (Photos)

  • Detail any spare ways within the Refrigeration Shop Services Distribution board?

  • Identify the location of the existing Front End / Alarm panel (Comments)

  • Identify the location of the existing Front End / Alarm panel (Photos & Markups)

  • Location of the main SIMS panels usually located on top of the cold rooms - (If IP)

Plant Details

  • Location of existing packs

  • Location of Exiting condensing units/Gas coolers

  • Photos / Markups of relevant existing packs, condensing units & Gas coolers

  • Identify any ball valves located on the roof and provide location information from the plant (Comments)

  • Identify any ball valves located on the roof and provide location information from the plant (Photos and Markup)

  • Check Sight Glasses for level (Photos)

  • Identify PRV expiry dates

  • Photos of pack Identification plates including Manufacture, Model, Serial Numbers

  • Refrigerant

  • Pack Gas Charge

  • Provide information on current Condensing units/ Gas cooler condition i.e. Housing, Coil etc (Comments)

  • Provide information on current Condensing units/ Gas cooler condition i.e. Housing, Coil etc (Photos)

  • Are General Layout Drawings Available?

  • Electronically?

  • Add Photos of General Layout Drawings Here

  • Where are these to be saved?

  • Are Pack flow Layout Drawings Available?

  • Electronically?

  • Add Photos of Pack flow Layout Drawings Here

  • Where are these to be saved?

  • Are Alarm Network Layout Drawings Available?

  • Electronically?

  • Add Photos of Alarm Network Layout Drawings Here

  • Where are these to be saved?

  • Any other comments, (access or store issues from store manager/maintenance manager that may implicate our works)

Sign Off

  • Sign off - Name & Signature

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