Title Page

  • Store Number

  • Store Name

  • Conducted on

  • Prepared by

  • Location

Store / Site detail

Survey Details

  • Store Number

  • Store Name

  • Date and time of the survey

  • Drawing ID and revision

  • Survey Controls and revision log

  • Amendments
  • Revision details Cash tube system information added

  • Add signature

Store Information

  • Manager

  • Managers Email

  • Direct phone number. Store/manager

  • Store trading hours

  • Money- Friday

  • Saturday

  • Sunday

  • Night shift/out of hours working arrangement. Add details

  • Landlord requirement. Add details

Checkout works

Belted Checkout works

  • Belted Checkout to be removed?

  • Checkout/s to be removed

  • Add photos

  • Belted Checkout to be repositioned?

  • Checkout/s to be repositioned

  • Add photos

Express checkout works

  • Express checkout to be removed?

  • Checkout/s to be removed

  • Add photos

  • Express checkout to be repositioned?

  • Checkout/s to be repositioned

  • Add media

  • Back to wall conversion required?

  • Detail of checkout to be converted

  • Add photos

  • Call light checkout renumbering required

  • Add detail

  • Add photos if required

Building works

Small building work requirements

  • Building works required?

  • Replace ceiling tiles?

  • Select ceiling tile type

  • Other type of ceiling tile?

  • Add detail

  • Add photos

  • Add detail. Quantity required

  • Add photos

  • Existing stud / partition wall to be modified?<br>

  • Select from follow options

  • Add detail of the required works.

  • Add media

  • New stud wall / partition / dwarf wall required <br>

  • Add detail of the required works.

  • Add media

  • Timber or joinery works required<br>

  • Add detail of the required works.

  • Add media

  • Any other small building works required?<br>

  • Add detail of the required works.

  • Add media

  • Wall mounted bumper rail modifications required<br>

  • Add detail of the required works.

  • Add media

  • Staff gate ways to Express till area repositioned?<br>

  • Add detail of the required works.

  • Add media

  • Any other small building works required?<br>

  • Add detail of the required works.

  • Add media

Lotto Counter

  • Lotto counter works?

  • Add detail

  • Add photos

  • Lotto counter worktop edge trim to be modified?

  • Add detail here

  • Add photos

  • Lotto monitor relocation?

  • Add detail here

  • Add photos

Cigarette Machine

Cigarette dispenser

  • Cigarette Machine works required

  • Cigarette dispensing machine works

  • Add detail

  • Add photos

Chrome rail and trolly bay works

Chrome rail and trolley bay works

  • Chrome rail installation/ alterations

  • Select from follow options

  • Add detail for each option selected

  • Add photos

  • Trolley bay relocation

  • Add detail

  • Type and quantity of fixing required

  • Add photos

Chiller / Fridge Relocation

Chiller/ Fridge Relocation

  • Are there any chiller units to be repositioned

  • Add detail

  • Add photos

Shelving modification

Shelving alterations required

  • Are there any shelving alterations required?

  • Add detail

  • Add photos

Sales floor furniture modications

Sales floor furniture modifications

  • Are there any sales floor furniture alterations required?

  • Add detail

  • Add photos

Cash tube system

Cash tube system information

  • System type

  • System tube diameter

  • Detail of cash tube system alterations

  • Is the cash tube system operational at the time of the survey?

  • Add details of any issues

Access Equipment Arrangements

Access delivery and storage detail

  • Add details of the location agreed with the store for the off loading and storage of any access equipment

  • Access equipment storage area

On site Start date

  • Planned Start Date

  • Planned Completion Date

  • Number of ALS fitters

Signage Work

Signage works

  • Are there any signage works required

  • Add detail

  • Add photos

Survey Sign Off

Survey sign off

  • Surveyor signature

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.