Co-operative Food; Floor Condition Survey

• Please tick the box if you have read and understand the accompanying Guidance Document. Failure to comply with the requirements set out in the Guidance Document could void this survey.

Please ensure all of the items below are completed accurately to ensure consistency

• Unique reference number (YYMMDD & Surveyor Number)

• Cedar Code (the store's unique code)

• Date of survey

  Date

• Weather conditions - please select one of the options that best describes today's weather

  Dry

  Mostly Dry

  Raining

  Ice/Snow

• Survey conducted by:

General Flooring Information

• What is the assumed age of the flooring type? Please use the comments box below for any additional information

  0-1yr

  1-3yrs

  3-6yrs

  6yrs+

• Add notes

• Click here to add photos of the specific area surveyed

  Media

• What is the flooring type?

  Select Sheet Vinyl Safety Vinyl In situ Resin Vinyl Tile Terrazzo Ceramic Tile Natural Stone Concrete Polished Concrete Other (please specify in comments)

  • Sheet Vinyl
  • Safety Vinyl
  • In situ Resin
  • Vinyl Tile
  • Terrazzo
  • Ceramic Tile
  • Natural Stone
  • Concrete
  • Polished Concrete
  • Other (please specify in comments)

• If other please specify

• Is the manufacturer known? Please add detail below

  Yes

  No - unknown

• Is there a permanent or temporary barrier matting solution in place? Please provide photo(s)

  Permanent Matting

  Temporary Matting

Condition & Renewal/Repair Cost

• What is the condition rating of this area of flooring? Please use the list below;<br><br>A = As new / Sound condition. <br>C = Average condition. Repair / replacement required in 2 - 5 years<br>E = Below average condition. Replacement required or likely within 1 year<br>J = Poor condition. Requires action within 1-3 months<br><br><br>

  A

  C

  E

  J

• Add photos

  Media

• For ratings A & C please provide an indicative cost to maintain the life expectancy of the flooring and for ratings E & J please provide indicative costs to carry out repairs/replacement.<br><br>Please provide appropriate commentary to support the recommendations and costs.

  £0-1k

  £1-2.5k

  £2.5-5k

  £5-10k

  £10k+

• Add notes

• Is there evidence of previous repairs? Please provide photographs of any repairs.

  Yes

  No

  N/A

Slip Resistance Testing

• What is the dry PTV rating? Please provide photographic evidence

  0-24

  25-35

  36+

• Add photos

  Media

• Please add any notes

• What is the wet PTV rating? Please provide photographic evidence

  0-24

  25-35

  36+

• Add photos

  Media

• Please add any notes

Dilapidations

• Are there any notable dilapidations? Please provide photographs

  Select None Wear & Tear Reparable Damage - Misuse Reparable Damage – Accidental Irreparable Damage – Replacement required

  • None
  • Wear & Tear
  • Reparable Damage - Misuse
  • Reparable Damage – Accidental
  • Irreparable Damage – Replacement required

• Add notes

• Add photos

  Media

General Flooring Information

• What is the assumed age of the flooring type? Please use the comments box below for any additional information

  0-1yr

  1-3yrs

  3-6yrs

  6yrs+

• Add notes

• Click here to add photos of the specific area surveyed

  Media

• What is the flooring type?

  Select Sheet Vinyl Safety Vinyl In situ Resin Vinyl Tile Terrazzo Ceramic Tile Natural Stone Concrete Polished Concrete Other (please specify in comments)

  • Sheet Vinyl
  • Safety Vinyl
  • In situ Resin
  • Vinyl Tile
  • Terrazzo
  • Ceramic Tile
  • Natural Stone
  • Concrete
  • Polished Concrete
  • Other (please specify in comments)

• If other please specify

• Is the manufacturer known? Please add detail below

  Yes

  No - unknown

• How many loose lay anti-slip mats are located on the shop floor?

  Select 0 1 2 3 4 5 6 7 8 More than 8

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • More than 8

• Following on from the previous question, is there an anti-slip mat placed under the flower display? (if flowers are on sale)

  Yes

  No - unknown

Condition & Renewal/Repair Cost

• What is the condition rating of this area of flooring? Please use the list below;<br><br>A = As new / Sound condition. <br>C = Average condition. Repair / replacement required in 2 - 5 years<br>E = Below average condition. Replacement required or likely within 1 year<br>J = Poor condition. Requires action within 1-3 months<br><br><br>

  A

  C

  E

  J

• Add photos

  Media

• For ratings A & C please provide an indicative cost to maintain the life expectancy of the flooring and for ratings E & J please provide indicative costs to carry out repairs/replacement.<br><br>Please provide appropriate commentary to support the recommendations and costs.

  £0-1k

  £1-2.5k

  £2.5-5k

  £5-10k

  £10k+

• Add notes

• Is there evidence of previous repairs? Please provide photographs of any repairs.

  Yes

  No

  N/A

Slip Resistance Training

• What is the dry PTV rating? Please provide photographic evidence

  0-24

  25-35

  36+

• Add photos

  Media

• Please add any notes

• What is the wet PTV rating? Please provide photographic evidence

  0-24

  25-35

  36+

• Add photos

  Media

• Please add any notes

Dilapidations

• Are there any notable dilapidations? Please provide photographs

  Select None Wear & Tear Reparable Damage - Misuse Reparable Damage – Accidental Irreparable Damage – Replacement required

  • None
  • Wear & Tear
  • Reparable Damage - Misuse
  • Reparable Damage – Accidental
  • Irreparable Damage – Replacement required

• Add notes

• Add photos

  Media

General Flooring Information

• What is the assumed age of the flooring type? Please use the comments box below for any additional information

  0-1yr

  1-3yrs

  3-6yrs

  6yrs+

• Add notes

• Click here to add photos of the specific area surveyed

  Media

• What is the flooring type?

  Select Sheet Vinyl Safety Vinyl In situ Resin Vinyl Tile Terrazzo Ceramic Tile Natural Stone Concrete Polished Concrete Other (please specify in comments)

  • Sheet Vinyl
  • Safety Vinyl
  • In situ Resin
  • Vinyl Tile
  • Terrazzo
  • Ceramic Tile
  • Natural Stone
  • Concrete
  • Polished Concrete
  • Other (please specify in comments)

• If other please specify

• Is the manufacturer known? Add detail below

  Yes

  No - unknown

Condition & Renewal/Repair Cost

• What is the condition rating of this area of flooring? Please use the list below;<br><br>A = As new / Sound condition. <br>C = Average condition. Repair / replacement required in 2 - 5 years<br>E = Below average condition. Replacement required or likely within 1 year<br>J = Poor condition. Requires action within 1-3 months<br><br><br>

  A

  C

  E

  J

• Add photos

  Media

• For ratings A & C please provide an indicative cost to maintain the life expectancy of the flooring and for ratings E & J please provide indicative costs to carry out repairs/replacement.<br><br>Please provide appropriate commentary to support the recommendations and costs.

  £0-1k

  £1-2.5k

  £2.5-5k

  £5-10k

  £10k+

• Add notes

Slip Resistance Testing

• What is the dry PTV rating? Please provide photographic evidence

  0-24

  25-35

  36+

• Add photos

  Media

• Please add any notes

• What is the wet PTV rating? Please provide photographic evidence

  0-24

  25-35

  36+

• Add photos

  Media

• Please add any notes

• Is there evidence of previous repairs? Please provide photographs of any repairs.

  Yes

  No

  N/A

Dilapidations

• Are there any notable dilapidations? Please provide photographs

  Select None Wear & Tear Reparable Damage - Misuse Reparable Damage – Accidental Irreparable Damage – Replacement required

  • None
  • Wear & Tear
  • Reparable Damage - Misuse
  • Reparable Damage – Accidental
  • Irreparable Damage – Replacement required

• Add notes

• Add photos

  Media

General Flooring Information

• What is the assumed age of the flooring type? Please use the comments box below for any additional information

  0-1yr

  1-3yrs

  3-6yrs

  6yrs+

• Add notes

• Click here to add photos of the specific area surveyed

  Media

• What is the flooring type?

  Select Sheet Vinyl Safety Vinyl In situ Resin Vinyl Tile Terrazzo Ceramic Tile Natural Stone Concrete Polished Concrete Other (please specify in comments)

  • Sheet Vinyl
  • Safety Vinyl
  • In situ Resin
  • Vinyl Tile
  • Terrazzo
  • Ceramic Tile
  • Natural Stone
  • Concrete
  • Polished Concrete
  • Other (please specify in comments)

• If other please specify

• Is the manufacturer known? Add detail below

  Yes

  No - unknown

Condition & Renewal/Repair Cost

• What is the condition rating of this area of flooring? Please use the list below;<br><br>A = As new / Sound condition. <br>C = Average condition. Repair / replacement required in 2 - 5 years<br>E = Below average condition. Replacement required or likely within 1 year<br>J = Poor condition. Requires action within 1-3 months<br><br><br>

  A

  C

  E

  J

• Add photos

  Media

• For ratings A & C please provide an indicative cost to maintain the life expectancy of the flooring and for ratings E & J please provide indicative costs to carry out repairs/replacement.<br><br>Please provide appropriate commentary to support the recommendations and costs.

  £0-1k

  £1-2.5k

  £2.5-5k

  £5-10k

  £10k+

• Add notes

• Is there evidence of previous repairs? Please provide photographs of any repairs.

  Yes

  No

  N/A

Slip Resistance Testing

• What is the dry PTV rating? Please provide photographic evidence

  0-24

  25-35

  36+

• Add photos

  Media

• Please add any notes

• What is the wet PTV rating? Please provide photographic evidence

  0-24

  25-35

  36+

• Add media

  Media

• Please add any notes

Dilapidations

• Are there any notable dilapidations? Please provide photographs

  Select None Wear & Tear Reparable Damage - Misuse Reparable Damage – Accidental Irreparable Damage – Replacement required

  • None
  • Wear & Tear
  • Reparable Damage - Misuse
  • Reparable Damage – Accidental
  • Irreparable Damage – Replacement required

• Add notes

• Add photos

  Media

General Flooring Information

• What is the assumed age of the flooring type? Please use the comments box below for any additional information

  0-1yr

  1-3yrs

  3-6yrs

  6yrs+

• Add notes

• Click here to add photos of the specific area surveyed

  Media

• What is the flooring type?

  Select Sheet Vinyl Safety Vinyl In situ Resin Vinyl Tile Terrazzo Ceramic Tile Natural Stone Concrete Polished Concrete Other (please specify in comments)

  • Sheet Vinyl
  • Safety Vinyl
  • In situ Resin
  • Vinyl Tile
  • Terrazzo
  • Ceramic Tile
  • Natural Stone
  • Concrete
  • Polished Concrete
  • Other (please specify in comments)

• If other please specify

• Is the manufacturer known? Add detail below

  Yes

  No - unknown

Condition & Renewal/Repair Cost

• What is the condition rating of this area of flooring? Please use the list below;<br><br>A = As new / Sound condition. <br>C = Average condition. Repair / replacement required in 2 - 5 years<br>E = Below average condition. Replacement required or likely within 1 year<br>J = Poor condition. Requires action within 1-3 months<br><br><br>

  A

  C

  E

  J

• Add photos

  Media

• For ratings A & C please provide an indicative cost to maintain the life expectancy of the flooring and for ratings E & J please provide indicative costs to carry out repairs/replacement.<br><br>Please provide appropriate commentary to support the recommendations and costs.

  £0-1k

  £1-2.5k

  £2.5-5k

  £5-10k

  £10k+

• Add notes

• Is there evidence of previous repairs? Please provide photographs of any repairs.

  Yes

  No

  N/A

Slip Resistance Testing

• What is the dry PTV rating? Please provide photographic evidence

  0-24

  25-35

  36+

• Add photos

  Media

• Please add any notes

• What is the wet PTV rating? Please provide photographic evidence

  0-24

  25-35

  36+

• Add photos

  Media

• Please add any notes

Dilapidations

• Are there any notable dilapidations? Please provide photographs

  Select None Wear & Tear Reparable Damage - Misuse Reparable Damage – Accidental Irreparable Damage – Replacement required

  • None
  • Wear & Tear
  • Reparable Damage - Misuse
  • Reparable Damage – Accidental
  • Irreparable Damage – Replacement required

• Add notes

• Add photos

  Media

General Flooring Information

• What is the assumed age of the flooring type? Please use the comments box below for any additional information

  0-1yr

  1-3yrs

  3-6yrs

  6yrs+

• Add notes

• Click here to add photos of the specific area surveyed

  Media

• What is the flooring type?

  Select Sheet Vinyl Safety Vinyl In situ Resin Vinyl Tile Terrazzo Ceramic Tile Natural Stone Concrete Polished Concrete Other (please specify in comments)

  • Sheet Vinyl
  • Safety Vinyl
  • In situ Resin
  • Vinyl Tile
  • Terrazzo
  • Ceramic Tile
  • Natural Stone
  • Concrete
  • Polished Concrete
  • Other (please specify in comments)

• If other please specify

• Is the manufacturer known? Add detail below

  Yes

  No - unknown

• Is there a permanent or temporary barrier matting solution in place? Please provide photo(s)

  Permanent Matting

  Temporary Matting

Condition & Renewal/Repair Cost

• What is the condition rating of this area of flooring? Please use the list below;<br><br>A = As new / Sound condition. <br>C = Average condition. Repair / replacement required in 2 - 5 years<br>E = Below average condition. Replacement required or likely within 1 year<br>J = Poor condition. Requires action within 1-3 months<br><br><br>

  A

  C

  E

  J

• Add photos

  Media

• For ratings A & C please provide an indicative cost to maintain the life expectancy of the flooring and for ratings E & J please provide indicative costs to carry out repairs/replacement.<br><br>Please provide appropriate commentary to support the recommendations and costs.

  £0-1k

  £1-2.5k

  £2.5-5k

  £5-10k

  £10k+

• Add notes

• Is there evidence of previous repairs? Please provide photographs of any repairs.

  Yes

  No

  N/A

Slip Resistance Testing

• What is the dry PTV rating? Please provide photographic evidence

  0-24

  25-35

  36+

• Add photos

  Media

• Please add any notes

• What is the wet PTV rating? Please provide photographic evidence

  0-24

  25-35

  36+

• Add photos

  Media

• Please add any notes

Dilapidations

• Are there any notable dilapidations? Please provide photographs

  Select None Wear & Tear Reparable Damage - Misuse Reparable Damage – Accidental Irreparable Damage – Replacement required

  • None
  • Wear & Tear
  • Reparable Damage - Misuse
  • Reparable Damage – Accidental
  • Irreparable Damage – Replacement required

• Add notes

• Add photos

  Media

General Flooring Information

• What is the assumed age of the flooring type? Please use the comments box below for any additional information

  0-1yr

  1-3yrs

  3-6yrs

  6yrs+

• Add notes

• Click here to add photos of the specific area surveyed

  Media

• What is the flooring type?

  Select Sheet Vinyl Safety Vinyl In situ Resin Vinyl Tile Terrazzo Ceramic Tile Natural Stone Concrete Polished Concrete Other (please specify in comments)

  • Sheet Vinyl
  • Safety Vinyl
  • In situ Resin
  • Vinyl Tile
  • Terrazzo
  • Ceramic Tile
  • Natural Stone
  • Concrete
  • Polished Concrete
  • Other (please specify in comments)

• If other please specify

• Is the manufacturer known? Add detail below

  Yes

  No - unknown

Condition & Renewal/Repair Cost

• What is the condition rating of this area of flooring? Please use the list below;<br><br>A = As new / Sound condition. <br>C = Average condition. Repair / replacement required in 2 - 5 years<br>E = Below average condition. Replacement required or likely within 1 year<br>J = Poor condition. Requires action within 1-3 months<br><br><br>

  A

  C

  E

  J

• Add photos

  Media

• For ratings A & C please provide an indicative cost to maintain the life expectancy of the flooring and for ratings E & J please provide indicative costs to carry out repairs/replacement.<br><br>Please provide appropriate commentary to support the recommendations and costs.

  £0-1k

  £1-2.5k

  £2.5-5k

  £5-10k

  £10k+

• Add notes

• Is there evidence of previous repairs? Please provide photographs of any repairs.

  Yes

  No

  N/A

Slip Resistance Testing

• What is the dry PTV rating? Please provide photographic evidence

  0-24

  25-35

  36+

• Add photos

  Media

• Please add any notes

• What is the wet PTV rating? Please provide photographic evidence

  0-24

  25-35

  36+

• Add photos

  Media

• Please add any notes

Dilapidations

• Are there any notable dilapidations? Please provide photographs

  Select None Wear & Tear Reparable Damage - Misuse Reparable Damage – Accidental Irreparable Damage – Replacement required

  • None
  • Wear & Tear
  • Reparable Damage - Misuse
  • Reparable Damage – Accidental
  • Irreparable Damage – Replacement required

• Add notes

• Add photos

  Media

In order to complete the survey you MUST obtain the name, signature and position of the Co-operative representative at this site

• Co-op representative

  Sign

• Full Name

• Position/Job Title

• Contractor representative

  Sign

• Full Name

• Position/Job Title