Title Page
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Survey Number (Auto Generated)
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Prepared by
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Site Name
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Conducted on
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Location
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Template Version 02 - 04/08/22
Initial Site Details
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Store Frontage Photo (Photo)
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Confirm you have signed in with store (Photo)
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Customer Project
- ABA
- Yo Sushi
- HFSS
- Other
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Other selected, define Project
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Brief Scope of Works
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Site-Specific arrangements (Parking Registration, Pay & Display, Part of Shopping Centre)
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Quantity of New Cases (Detail to be input later in survey)
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Quantity of Cases being Removed (Detail to be input later in survey)
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Quantity of Cases Relocating (Detail to be input later in survey)
New Cabinets
- New Cases (Add new for each run of cases being removed)
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Case Numbers (if known) & Type
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Supplier and Model Names
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Remote or Integral
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Refrigerant
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Proposed Location (Markup Drawing & Photo)
Services
Refrigeration Services
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Cabinet Refrig Services - Top or Bottom Entry
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Description of Route (Pack, Service route including bends and wall penetrations, etc)
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Pipe Sizes
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Ball Valve Location
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Ball Valve Location (Photo & Markup)
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Approx route length (metres)
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Photos & Markup of Route (Include any proposed service T locations)
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Containment Required? (Pearling clips, window brackets etc?)
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Other relevant existing Services Photos / Markups
Electrical Services (See Previous Section for Shop Services DB Details)
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Cabinet Electrical Services - Top or Bottom Entry
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Description of Cable Route (including wall penetrations etc)
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Local Distribution Board Identification including location in the store
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Photo of existing Local DB schedule
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Available spare ways on board?
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DB Supply cable type and size?
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Approx route length to case (metres)
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Photos & markup of Route
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Containment Required? (Pearling clips, window brackets etc?)
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Other relevant existing Services Photos / Markups
Drainage Services
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Description of requirements, Location, Type and pipe size
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Drainage Type (Pumped or Gravity?)
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Approx route length (metres)
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Photos /Markup of Route
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Containment Required? (Pearling clips, window brackets etc?)
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Other relevant existing Services Photos
Data Services
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Type - IP or Serial (RS485)
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Description of Route, nearest HUB location, spare ports
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Approx route length (metres)
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Colour of cables used onsite
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Photos & markup of Route
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Containment Required? (Pearling clips, window brackets etc?)
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Other relevant existing Services Photos
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Works to Service Columns required? (Round or Square)
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Works to Service Columns required? (Cutting, Repairing, Relocations)
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Round or Square?
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Location
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Photo
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Is Cold Air Retrieval in Use?
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Any Builders Works Required?
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Any Under floor contaiment required
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List Materials Required for new case?
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Other relevant existing Services Photos/Markups
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Other Relevant New Case Notes
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Cabinet Removals
- Removals (Select 'Add New' for each run of cases being removed)
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Case Numbers & Types to be Removed
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Supplier and Model Names
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Case Serial Numbers
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Case Photos
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Serial Plate Photos
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Refrigerant
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Remote or Integral?
Services
Refrigeration Services
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Cabinet Refrigeration Services - Top or Bottom Entry
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Description of Services to be cut back (Pack,route including wall penetrations, pipe sizes etc)
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Ball Valve Location
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Ball Valve Location (Photo & Markup)
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Approx route length to be removed (metres)
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Photos & Markup of Route
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Any Containment works Required? Removal and Installation?
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Other relevant existing Services Photos / Markups
Electrical Services (See Previous Section for Shop Services DB Details)
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Cabinet Electrical Services - Top or Bottom Entry
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Description of Services to be cut back (Including wall penetrations, breakers or DB's to be removed, etc?)
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Local Supply Distribution Board Identification including location in the store
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Photo of existing Local DB schedule
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Approx route length to case to be removed (metres)
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Photos & Markup of Route
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Any Containment works Required? Removal and Installation?
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Other relevant existing Electrical Photos / Markups
Drainage Services
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Description of Existing drainage? Location, Type and pipe size
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Drainage Type (Pumped or Gravity?)
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Approx route length to be removed (metres)
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Photos & Markup of Route
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Any Containment works Required? Removal and Installation?
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Other relevant existing Drainage Photos / Markups
Data Services
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Type - IP or Serial (RS485)
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Description of new data cable route, (nearest HUB location, spare ports, etc)
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Approx route length (metres)
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Colour of cables used onsite
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Photos & Markup of Route
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Any Containment works Required? Removal and Installation?
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Other relevant existing Data Photos / Markups
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Works to Service Columns required? (Round or Square)
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Works to Service Columns required? (Cutting, Repairing, Relocations)
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Round or Square?
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Location
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Photo
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Is Cold Air Retrieval in Use?
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Any Builders Works Required?
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Any Under floor contaiment required
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List Materials Required for the removal of case?
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Other relevant existing Services Photos/Markups
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Other Relevant Case Removal Notes
Cabinet Relocations
Case Relocations (Add new for each run of cases being relocated)
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Case Number & Type to be Relocated
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Supplier and Model Names
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Case Serial Numbers
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Case Photos
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Serial Plate Photos
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Refrigerant
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Remote or Integral?
Services
Refrigeration Services
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Cabinet Refrigeration Services - Top or Bottom Entry
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Description of Services to be relocated (Pack, route including wall penetrations, etc)
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Pipe sizes
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Existing Ball Valve Location
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Existing Ball Valve Location (Photo & Markup)
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Approx route length to be removed (metres)
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Approx route length to be added (metres)
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Photos & markup of Routes (Existing and New)
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Any Containment works Required? Removal and Installation?
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Other relevant existing Services Photos / Markups
Electrical Services (See Next Section for Main BOH Shop Services DB Details)
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Cabinet Electrical Services - Top or Bottom Entry
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Description of Services to be relocated (Including wall penetrations, breakers or DB's to be (re)moved, etc?)
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Local Supply Distribution Board Identification including location in the store
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Photo of existing Local DB schedule
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Approx route length to the case to be removed (metres)
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Approx route length to be added (metres)
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Photos & Markup of Routes (Existing and New)
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Any Containment works Required? Removal and Installation?
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Other relevant existing Electrical Photos / Markups
Drainage Services
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Description of Existing drainage? Location, Type and pipe size
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Description of New drainage arrangement? Location, Type and pipe size
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Drainage Type in Existing Location (Pumped or Gravity?)
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Drainage Type in New Location (Pumped or Gravity?)
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Approx route length to be removed (metres)
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Approx route length to be added (metres)
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Photos & Markup of Routes (Existing and New)
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Any Containment works Required? Removal and Installation?
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Other relevant existing Drainage Photos / Markups
Data Services
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Type - IP or Serial (RS485)
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Description of the existing data cable route.
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Description of new data cable route (nearest HUB location, spare ports, etc)
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Approx route length to be removed (metres)
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Approx route length to be added (metres)
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Colour of cables used onsite
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Photos & Markup of Routes (Existing and New)
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Any Containment works Required? Removal and Installation?
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Other relevant existing Data Photos / Markups
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Works to Service Columns required? (Round or Square)
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Works to Service Columns required? (Cutting, Repairing, Relocations)
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Round or Square?
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Location
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Photo
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Is Cold Air Retrieval in Use?
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Any Builders Works Required?
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Any Under floor contaiment required
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List Materials Required for the removal of case?
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Other relevant existing Services Photos/Markups
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Other Relevant Case Removal Notes
Further Site-Specific Detail
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Store Ceiling Type / Heights (Suspended Ceiling or Open?)
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Will a Scissor Lift be required? Type? Height?
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Restricted area details, Keys location/numbers for Roof, plant rooms etc
Warehouse Details
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Identify Refrigeration Shop Services Distribution board locations (Comments)
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Identify Refrigeration Shop Services Distribution board locations (Photographs)
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Distribution Board Schedules/Circuit information within the boards? (Photos)
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Detail any spare ways within the Refrigeration Shop Services Distribution board?
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Identify the location of the existing Front End / Alarm panel (Comments)
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Identify the location of the existing Front End / Alarm panel (Photos & Markups)
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Location of the main SIMS panels usually located on top of the cold rooms - (If IP)
Plant Details
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Location of existing packs
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Location of Exiting condensing units/Gas coolers
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Photos / Markups of relevant existing packs, condensing units & Gas coolers
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Identify any ball valves located on the roof and provide location information from the plant (Comments)
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Identify any ball valves located on the roof and provide location information from the plant (Photos and Markup)
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Check Sight Glasses for level (Photos)
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Identify PRV expiry dates
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Photos of pack Identification plates including Manufacture, Model, Serial Numbers
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Refrigerant
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Pack Gas Charge
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Provide information on current Condensing units/ Gas cooler condition i.e. Housing, Coil etc (Comments)
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Provide information on current Condensing units/ Gas cooler condition i.e. Housing, Coil etc (Photos)
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Are General Layout Drawings Available?
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Electronically?
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Add Photos of General Layout Drawings Here
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Where are these to be saved?
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Are Pack flow Layout Drawings Available?
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Electronically?
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Add Photos of Pack flow Layout Drawings Here
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Where are these to be saved?
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Are Alarm Network Layout Drawings Available?
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Electronically?
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Add Photos of Alarm Network Layout Drawings Here
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Where are these to be saved?
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Any other comments, (access or store issues from store manager/maintenance manager that may implicate our works)
Sign Off
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Sign off - Name & Signature