Information

  • Audit Title

  • Store picture

  • Store Number and Name

  • Store Manager

  • IST name and contact

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Notes

  • Asbestos Store?

Night Survey

Lighting

  • Main lighting control

  • Off peak lighting oppertunity?

  • Average off peak lux

  • H&B lights on?

  • TV Wall on?<br>

  • Laptops on?

  • BOS PIR oppertunity?

  • Clothing/feature spot lights on?<br>

  • Card Shelf under lighting on

  • PFS lighting on?

Refrigeration

  • Chilled cabinets on?

  • Produce lights on?

  • FHGD on

  • HHGD lights on

Other

  • Door Curtains on?

  • Pasty Oven on

  • Hot Chicken self serve on?

  • Other Project descriptions
  • Project

  • Drawing 1

Off peak lux survey

  • Notes


  • Min and max lux levels
  • Row number or area.

  • Notes

  • Max lux

  • Min lux

  • Pics

Day Survey

FOS Lighting

  • Lighting controller located? type and location

  • Cross floor lighting dimming oppertunity?

  • Average cross floor lux

  • FOS Project description, pictures and drawings

  • Project
  • Project

  • Project details

  • Drawing

BOS Lighting

  • BOS PIR opportunities? offices, staff room, bulkstore, external?

  • BOS lux opportunities? bulkstore cow shed, external?

  • BOS Project description, pictures and drawings

  • Project
  • Project

  • Project description

  • Drawing

Refrigeration

  • Cold room lighting control in place?

  • LED lighting in freezer rooms?

  • Refridge Project description, pictures and drawings

  • Project
  • Project

  • Project description

  • Drawing

HVAC

  • HVAC Project description, pictures and drawings

  • Project
  • Project

  • Project Description

  • Drawing

Other

  • Other Project description, pictures and drawings

  • Project
  • Project

  • Project Description

  • Drawing

Day lux survey

  • Notes

  • Min and max lux levels

  • ,I'm and ,ax
  • Row number or area

  • Notes

  • Minimum lux

  • Maximum lux

  • Pictures

Store existing issues

    Existing issues on site
  • Issue

  • Details of previous issues identified at the store

  • Drawing

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.