Ems

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Store Representative Title

  Select SM:1:230,230,230 STM:0:230,230,230 SSM:1:230,230,230 DM:1:230,230,230 Other store personnel :1:230,230,230 1

  • SM:1:230,230,230
  • STM:0:230,230,230
  • SSM:1:230,230,230
  • DM:1:230,230,230
  • Other store personnel :1:230,230,230
  • 1

• Conducted on

  Date

Contractor Management

• Are all restricted areas locked and signage clearly displayed?

  Yes

  No

  N/A

• Are technicians on site Pegasus inducted?

  Yes

  No

  N/A

• Add media

  Media

Emergency Management

• Are assembly areas allocated and understood?

  Yes

  No

  N/A

• Has a practice drill occurred in the last six months?

  Yes

  No

  N/A

• Are the means of escape paths and emergency exits clear?

  Yes

  No

  N/A

• Add media

  Media

Fire Services and Protection Systems

Fire Extinguishers

• Are they within 6 month of the test date

  Yes

  No

  N/A

• Date Last Tested?

  Select jan 2013::0,0,255 feb 2013::63,0,255 mar 2013::63,0,255 apr 2013::63,0,255 may 2013::63,0,255 jun 2013::63,0,255 jul 2013::63,0,255 aug 2013::63,0,255 sep 2013::63,0,255 oct 2013::63,0,255 nov 2013::63,0,255 dec 2013::63,0,255 jan 2012::63,0,255 feb 2012::63,0,255 mar 2012::0,0,255 apr 2012::53,0,221 may 2012::0,0,255 jun 2012::63,0,255 jul 2012::0,0,221 aug 2012::63,0,255 sept 2012::63,0,255 oct 2012::53,0,221 nov 2012::53,0,221 dec 2012::63,0,255 jan 2011::0,0,221 feb 2011::63,0,255 mar 2011::53,0,221 apr 2011::53,0,221 may 2011::0,0,221 apr 2011::0,0,255 may 2011::53,0,221 jun 2011::53,0,221 jul 2011::53,0,221 aug 2011::0,0,255 sep 2011::0,0,255 oct 2011::0,0,221 nov 2011::0,0,255 dec 2011::63,0,255 jan 2010::0,0,221 feb 2010::0,0,255 mar 2010::0,0,255 apr 2010::63,0,255 may 2010::53,0,221 jun 2010::0,0,221 jul 2010::0,0,221 aug 2010::0,44,221 sep 2010::0,0,255 oct 2010::0,0,221 nov 2010::63,0,255 dec2010::0,0,255 1

  • jan 2013::0,0,255
  • feb 2013::63,0,255
  • mar 2013::63,0,255
  • apr 2013::63,0,255
  • may 2013::63,0,255
  • jun 2013::63,0,255
  • jul 2013::63,0,255
  • aug 2013::63,0,255
  • sep 2013::63,0,255
  • oct 2013::63,0,255
  • nov 2013::63,0,255
  • dec 2013::63,0,255
  • jan 2012::63,0,255
  • feb 2012::63,0,255
  • mar 2012::0,0,255
  • apr 2012::53,0,221
  • may 2012::0,0,255
  • jun 2012::63,0,255
  • jul 2012::0,0,221
  • aug 2012::63,0,255
  • sept 2012::63,0,255
  • oct 2012::53,0,221
  • nov 2012::53,0,221
  • dec 2012::63,0,255
  • jan 2011::0,0,221
  • feb 2011::63,0,255
  • mar 2011::53,0,221
  • apr 2011::53,0,221
  • may 2011::0,0,221
  • apr 2011::0,0,255
  • may 2011::53,0,221
  • jun 2011::53,0,221
  • jul 2011::53,0,221
  • aug 2011::0,0,255
  • sep 2011::0,0,255
  • oct 2011::0,0,221
  • nov 2011::0,0,255
  • dec 2011::63,0,255
  • jan 2010::0,0,221
  • feb 2010::0,0,255
  • mar 2010::0,0,255
  • apr 2010::63,0,255
  • may 2010::53,0,221
  • jun 2010::0,0,221
  • jul 2010::0,0,221
  • aug 2010::0,44,221
  • sep 2010::0,0,255
  • oct 2010::0,0,221
  • nov 2010::63,0,255
  • dec2010::0,0,255
  • 1

• Are inspection tags securely fitted to device and stamped.

  Yes

  No

  N/A

• Is there clear access to Fire Equipment.

  Yes

  No

  N/A

• Are items securely fixed to the wall

  Yes

  No

  N/A

• Is signage in place

  Yes

  No

  N/A

• Add media

  Media

Fire Hose Reels

• Are they within 6 month test date

  Yes

  No

  N/A

• Date last tested

  Select jan 2013::0,0,255 feb 2013::63,0,255 mar 2013::63,0,255 apr 2013::63,0,255 may 2013::63,0,255 jun 2013::63,0,255 jul 2013::63,0,255 aug 2013::63,0,255 sep 2013::63,0,255 oct 2013::63,0,255 nov 2013::63,0,255 dec 2013::63,0,255 jan 2012::63,0,255 feb 2012::63,0,255 mar 2012::0,0,255 apr 2012::53,0,221 may 2012::0,0,255 jun 2012::63,0,255 jul 2012::0,0,221 aug 2012::63,0,255 sept 2012::63,0,255 oct 2012::53,0,221 nov 2012::53,0,221 dec 2012::63,0,255 jan 2011::0,0,221 feb 2011::63,0,255 mar 2011::53,0,221 apr 2011::53,0,221 may 2011::0,0,221 apr 2011::0,0,255 may 2011::53,0,221 jun 2011::53,0,221 jul 2011::53,0,221 aug 2011::0,0,255 sep 2011::0,0,255 oct 2011::0,0,221 nov 2011::0,0,255 dec 2011::63,0,255 jan 2010::0,0,221 feb 2010::0,0,255 mar 2010::0,0,255 apr 2010::63,0,255 may 2010::53,0,221 jun 2010::0,0,221 jul 2010::0,0,221 aug 2010::0,44,221 sep 2010::0,0,255 oct 2010::0,0,221 nov 2010::63,0,255 dec2010::0,0,255 1

  • jan 2013::0,0,255
  • feb 2013::63,0,255
  • mar 2013::63,0,255
  • apr 2013::63,0,255
  • may 2013::63,0,255
  • jun 2013::63,0,255
  • jul 2013::63,0,255
  • aug 2013::63,0,255
  • sep 2013::63,0,255
  • oct 2013::63,0,255
  • nov 2013::63,0,255
  • dec 2013::63,0,255
  • jan 2012::63,0,255
  • feb 2012::63,0,255
  • mar 2012::0,0,255
  • apr 2012::53,0,221
  • may 2012::0,0,255
  • jun 2012::63,0,255
  • jul 2012::0,0,221
  • aug 2012::63,0,255
  • sept 2012::63,0,255
  • oct 2012::53,0,221
  • nov 2012::53,0,221
  • dec 2012::63,0,255
  • jan 2011::0,0,221
  • feb 2011::63,0,255
  • mar 2011::53,0,221
  • apr 2011::53,0,221
  • may 2011::0,0,221
  • apr 2011::0,0,255
  • may 2011::53,0,221
  • jun 2011::53,0,221
  • jul 2011::53,0,221
  • aug 2011::0,0,255
  • sep 2011::0,0,255
  • oct 2011::0,0,221
  • nov 2011::0,0,255
  • dec 2011::63,0,255
  • jan 2010::0,0,221
  • feb 2010::0,0,255
  • mar 2010::0,0,255
  • apr 2010::63,0,255
  • may 2010::53,0,221
  • jun 2010::0,0,221
  • jul 2010::0,0,221
  • aug 2010::0,44,221
  • sep 2010::0,0,255
  • oct 2010::0,0,221
  • nov 2010::63,0,255
  • dec2010::0,0,255
  • 1

• Are inspection tags securely fitted to device and stamped.

  Yes

  No

  N/A

• Is there clear access to Fire Equipment.

  Yes

  No

  N/A

• Are items securely fixed to the wall

  Yes

  No

  N/A

• Is signage in place

  Yes

  No

  N/A

• Are Fire Cupboards (hose reel storage etc) free from stored materials and rubbish?

  Yes

  No

  N/A

• Is access to fire cupboards unimpeded?

  Yes

  No

  N/A

• Add media

  Media

Fire Blankets

• Are they within 6 month test dates

  Yes

  No

  N/A

• Date last tested

  Select jan 2013::0,0,255 feb 2013::63,0,255 mar 2013::63,0,255 apr 2013::63,0,255 may 2013::63,0,255 jun 2013::63,0,255 jul 2013::63,0,255 aug 2013::63,0,255 sep 2013::63,0,255 oct 2013::63,0,255 nov 2013::63,0,255 dec 2013::63,0,255 jan 2012::63,0,255 feb 2012::63,0,255 mar 2012::0,0,255 apr 2012::53,0,221 may 2012::0,0,255 jun 2012::63,0,255 jul 2012::0,0,221 aug 2012::63,0,255 sept 2012::63,0,255 oct 2012::53,0,221 nov 2012::53,0,221 dec 2012::63,0,255 jan 2011::0,0,221 feb 2011::63,0,255 mar 2011::53,0,221 apr 2011::53,0,221 may 2011::0,0,221 apr 2011::0,0,255 may 2011::53,0,221 jun 2011::53,0,221 jul 2011::53,0,221 aug 2011::0,0,255 sep 2011::0,0,255 oct 2011::0,0,221 nov 2011::0,0,255 dec 2011::63,0,255 jan 2010::0,0,221 feb 2010::0,0,255 mar 2010::0,0,255 apr 2010::63,0,255 may 2010::53,0,221 jun 2010::0,0,221 jul 2010::0,0,221 aug 2010::0,44,221 sep 2010::0,0,255 oct 2010::0,0,221 nov 2010::63,0,255 dec2010::0,0,255 1

  • jan 2013::0,0,255
  • feb 2013::63,0,255
  • mar 2013::63,0,255
  • apr 2013::63,0,255
  • may 2013::63,0,255
  • jun 2013::63,0,255
  • jul 2013::63,0,255
  • aug 2013::63,0,255
  • sep 2013::63,0,255
  • oct 2013::63,0,255
  • nov 2013::63,0,255
  • dec 2013::63,0,255
  • jan 2012::63,0,255
  • feb 2012::63,0,255
  • mar 2012::0,0,255
  • apr 2012::53,0,221
  • may 2012::0,0,255
  • jun 2012::63,0,255
  • jul 2012::0,0,221
  • aug 2012::63,0,255
  • sept 2012::63,0,255
  • oct 2012::53,0,221
  • nov 2012::53,0,221
  • dec 2012::63,0,255
  • jan 2011::0,0,221
  • feb 2011::63,0,255
  • mar 2011::53,0,221
  • apr 2011::53,0,221
  • may 2011::0,0,221
  • apr 2011::0,0,255
  • may 2011::53,0,221
  • jun 2011::53,0,221
  • jul 2011::53,0,221
  • aug 2011::0,0,255
  • sep 2011::0,0,255
  • oct 2011::0,0,221
  • nov 2011::0,0,255
  • dec 2011::63,0,255
  • jan 2010::0,0,221
  • feb 2010::0,0,255
  • mar 2010::0,0,255
  • apr 2010::63,0,255
  • may 2010::53,0,221
  • jun 2010::0,0,221
  • jul 2010::0,0,221
  • aug 2010::0,44,221
  • sep 2010::0,0,255
  • oct 2010::0,0,221
  • nov 2010::63,0,255
  • dec2010::0,0,255
  • 1

• Are inspection tags securely fitted to device and stamped.

  Yes

  No

  N/A

• Is there clear access to Fire Equipment.

  Yes

  No

  N/A

• Are items securely fixed to the wall

  Yes

  No

  N/A

• Is signage in place

  Yes

  No

  N/A

• Add media

  Media

Fire Hydrants

• Are they within 6 month test dates

  Yes

  No

  N/A

• Date last tested

  Select jan 2013::0,0,255 feb 2013::63,0,255 mar 2013::63,0,255 apr 2013::63,0,255 may 2013::63,0,255 jun 2013::63,0,255 jul 2013::63,0,255 aug 2013::63,0,255 sep 2013::63,0,255 oct 2013::63,0,255 nov 2013::63,0,255 dec 2013::63,0,255 jan 2012::63,0,255 feb 2012::63,0,255 mar 2012::0,0,255 apr 2012::53,0,221 may 2012::0,0,255 jun 2012::63,0,255 jul 2012::0,0,221 aug 2012::63,0,255 sept 2012::63,0,255 oct 2012::53,0,221 nov 2012::53,0,221 dec 2012::63,0,255 jan 2011::0,0,221 feb 2011::63,0,255 mar 2011::53,0,221 apr 2011::53,0,221 may 2011::0,0,221 apr 2011::0,0,255 may 2011::53,0,221 jun 2011::53,0,221 jul 2011::53,0,221 aug 2011::0,0,255 sep 2011::0,0,255 oct 2011::0,0,221 nov 2011::0,0,255 dec 2011::63,0,255 jan 2010::0,0,221 feb 2010::0,0,255 mar 2010::0,0,255 apr 2010::63,0,255 may 2010::53,0,221 jun 2010::0,0,221 jul 2010::0,0,221 aug 2010::0,44,221 sep 2010::0,0,255 oct 2010::0,0,221 nov 2010::63,0,255 dec2010::0,0,255 1

  • jan 2013::0,0,255
  • feb 2013::63,0,255
  • mar 2013::63,0,255
  • apr 2013::63,0,255
  • may 2013::63,0,255
  • jun 2013::63,0,255
  • jul 2013::63,0,255
  • aug 2013::63,0,255
  • sep 2013::63,0,255
  • oct 2013::63,0,255
  • nov 2013::63,0,255
  • dec 2013::63,0,255
  • jan 2012::63,0,255
  • feb 2012::63,0,255
  • mar 2012::0,0,255
  • apr 2012::53,0,221
  • may 2012::0,0,255
  • jun 2012::63,0,255
  • jul 2012::0,0,221
  • aug 2012::63,0,255
  • sept 2012::63,0,255
  • oct 2012::53,0,221
  • nov 2012::53,0,221
  • dec 2012::63,0,255
  • jan 2011::0,0,221
  • feb 2011::63,0,255
  • mar 2011::53,0,221
  • apr 2011::53,0,221
  • may 2011::0,0,221
  • apr 2011::0,0,255
  • may 2011::53,0,221
  • jun 2011::53,0,221
  • jul 2011::53,0,221
  • aug 2011::0,0,255
  • sep 2011::0,0,255
  • oct 2011::0,0,221
  • nov 2011::0,0,255
  • dec 2011::63,0,255
  • jan 2010::0,0,221
  • feb 2010::0,0,255
  • mar 2010::0,0,255
  • apr 2010::63,0,255
  • may 2010::53,0,221
  • jun 2010::0,0,221
  • jul 2010::0,0,221
  • aug 2010::0,44,221
  • sep 2010::0,0,255
  • oct 2010::0,0,221
  • nov 2010::63,0,255
  • dec2010::0,0,255
  • 1

• Are inspection tags securely fitted to device and stamped.

  Yes

  No

  N/A

• Is there clear access to Fire Equipment.

  Yes

  No

  N/A

• Are items securely fixed to the wall

  Yes

  No

  N/A

• Is signage in place

  Yes

  No

  N/A

• Add media

  Media

Fire / Emergency - Exit / Doors Stairwells

• Within PM test date

  Yes

  No

  N/A

• Date last tested

  Select jan 2013::0,0,255 feb 2013::63,0,255 mar 2013::63,0,255 apr 2013::63,0,255 may 2013::63,0,255 jun 2013::63,0,255 jul 2013::63,0,255 aug 2013::63,0,255 sep 2013::63,0,255 oct 2013::63,0,255 nov 2013::63,0,255 dec 2013::63,0,255 jan 2012::63,0,255 feb 2012::63,0,255 mar 2012::0,0,255 apr 2012::53,0,221 may 2012::0,0,255 jun 2012::63,0,255 jul 2012::0,0,221 aug 2012::63,0,255 sept 2012::63,0,255 oct 2012::53,0,221 nov 2012::53,0,221 dec 2012::63,0,255 jan 2011::0,0,221 feb 2011::63,0,255 mar 2011::53,0,221 apr 2011::53,0,221 may 2011::0,0,221 apr 2011::0,0,255 may 2011::53,0,221 jun 2011::53,0,221 jul 2011::53,0,221 aug 2011::0,0,255 sep 2011::0,0,255 oct 2011::0,0,221 nov 2011::0,0,255 dec 2011::63,0,255 jan 2010::0,0,221 feb 2010::0,0,255 mar 2010::0,0,255 apr 2010::63,0,255 may 2010::53,0,221 jun 2010::0,0,221 jul 2010::0,0,221 aug 2010::0,44,221 sep 2010::0,0,255 oct 2010::0,0,221 nov 2010::63,0,255 dec2010::0,0,255 1

  • jan 2013::0,0,255
  • feb 2013::63,0,255
  • mar 2013::63,0,255
  • apr 2013::63,0,255
  • may 2013::63,0,255
  • jun 2013::63,0,255
  • jul 2013::63,0,255
  • aug 2013::63,0,255
  • sep 2013::63,0,255
  • oct 2013::63,0,255
  • nov 2013::63,0,255
  • dec 2013::63,0,255
  • jan 2012::63,0,255
  • feb 2012::63,0,255
  • mar 2012::0,0,255
  • apr 2012::53,0,221
  • may 2012::0,0,255
  • jun 2012::63,0,255
  • jul 2012::0,0,221
  • aug 2012::63,0,255
  • sept 2012::63,0,255
  • oct 2012::53,0,221
  • nov 2012::53,0,221
  • dec 2012::63,0,255
  • jan 2011::0,0,221
  • feb 2011::63,0,255
  • mar 2011::53,0,221
  • apr 2011::53,0,221
  • may 2011::0,0,221
  • apr 2011::0,0,255
  • may 2011::53,0,221
  • jun 2011::53,0,221
  • jul 2011::53,0,221
  • aug 2011::0,0,255
  • sep 2011::0,0,255
  • oct 2011::0,0,221
  • nov 2011::0,0,255
  • dec 2011::63,0,255
  • jan 2010::0,0,221
  • feb 2010::0,0,255
  • mar 2010::0,0,255
  • apr 2010::63,0,255
  • may 2010::53,0,221
  • jun 2010::0,0,221
  • jul 2010::0,0,221
  • aug 2010::0,44,221
  • sep 2010::0,0,255
  • oct 2010::0,0,221
  • nov 2010::63,0,255
  • dec2010::0,0,255
  • 1

• Emergency paths of travel are clear (internal and external)

  Yes

  No

  N/A

• Are the Fire Doors in sound condition

  Yes

  No

  N/A

• Are ALL Fire Doors / Breakout panels operational?

  Yes

  No

  N/A

• Add media

  Media

Annual Fire Safety Statement

• Annual Fire Safety Statement on site

  Yes

  No

  N/A

• Date last certified

  Select jan 2013::0,0,255 feb 2013::63,0,255 mar 2013::63,0,255 apr 2013::63,0,255 may 2013::63,0,255 jun 2013::63,0,255 jul 2013::63,0,255 aug 2013::63,0,255 sep 2013::63,0,255 oct 2013::63,0,255 nov 2013::63,0,255 dec 2013::63,0,255 jan 2012::63,0,255 feb 2012::63,0,255 mar 2012::0,0,255 apr 2012::53,0,221 may 2012::0,0,255 jun 2012::63,0,255 jul 2012::0,0,221 aug 2012::63,0,255 sept 2012::63,0,255 oct 2012::53,0,221 nov 2012::53,0,221 dec 2012::63,0,255 jan 2011::0,0,221 feb 2011::63,0,255 mar 2011::53,0,221 apr 2011::53,0,221 may 2011::0,0,221 apr 2011::0,0,255 may 2011::53,0,221 jun 2011::53,0,221 jul 2011::53,0,221 aug 2011::0,0,255 sep 2011::0,0,255 oct 2011::0,0,221 nov 2011::0,0,255 dec 2011::63,0,255 jan 2010::0,0,221 feb 2010::0,0,255 mar 2010::0,0,255 apr 2010::63,0,255 may 2010::53,0,221 jun 2010::0,0,221 jul 2010::0,0,221 aug 2010::0,44,221 sep 2010::0,0,255 oct 2010::0,0,221 nov 2010::63,0,255 dec2010::0,0,255 1

  • jan 2013::0,0,255
  • feb 2013::63,0,255
  • mar 2013::63,0,255
  • apr 2013::63,0,255
  • may 2013::63,0,255
  • jun 2013::63,0,255
  • jul 2013::63,0,255
  • aug 2013::63,0,255
  • sep 2013::63,0,255
  • oct 2013::63,0,255
  • nov 2013::63,0,255
  • dec 2013::63,0,255
  • jan 2012::63,0,255
  • feb 2012::63,0,255
  • mar 2012::0,0,255
  • apr 2012::53,0,221
  • may 2012::0,0,255
  • jun 2012::63,0,255
  • jul 2012::0,0,221
  • aug 2012::63,0,255
  • sept 2012::63,0,255
  • oct 2012::53,0,221
  • nov 2012::53,0,221
  • dec 2012::63,0,255
  • jan 2011::0,0,221
  • feb 2011::63,0,255
  • mar 2011::53,0,221
  • apr 2011::53,0,221
  • may 2011::0,0,221
  • apr 2011::0,0,255
  • may 2011::53,0,221
  • jun 2011::53,0,221
  • jul 2011::53,0,221
  • aug 2011::0,0,255
  • sep 2011::0,0,255
  • oct 2011::0,0,221
  • nov 2011::0,0,255
  • dec 2011::63,0,255
  • jan 2010::0,0,221
  • feb 2010::0,0,255
  • mar 2010::0,0,255
  • apr 2010::63,0,255
  • may 2010::53,0,221
  • jun 2010::0,0,221
  • jul 2010::0,0,221
  • aug 2010::0,44,221
  • sep 2010::0,0,255
  • oct 2010::0,0,221
  • nov 2010::63,0,255
  • dec2010::0,0,255
  • 1

Fire Indicator Panel

• Is the fire indicator panel maintained by Centre Management?

  Yes

  No

  N/A

• If the system is maintained by retailer is it within PM test date (monthly)

  Yes

  No

  N/A

• Date last tested

  Select jan 2013::0,0,255 feb 2013::63,0,255 mar 2013::63,0,255 apr 2013::63,0,255 may 2013::63,0,255 jun 2013::63,0,255 jul 2013::63,0,255 aug 2013::63,0,255 sep 2013::63,0,255 oct 2013::63,0,255 nov 2013::63,0,255 dec 2013::63,0,255 jan 2012::63,0,255 feb 2012::63,0,255 mar 2012::0,0,255 apr 2012::53,0,221 may 2012::0,0,255 jun 2012::63,0,255 jul 2012::0,0,221 aug 2012::63,0,255 sept 2012::63,0,255 oct 2012::53,0,221 nov 2012::53,0,221 dec 2012::63,0,255 jan 2011::0,0,221 feb 2011::63,0,255 mar 2011::53,0,221 apr 2011::53,0,221 may 2011::0,0,221 apr 2011::0,0,255 may 2011::53,0,221 jun 2011::53,0,221 jul 2011::53,0,221 aug 2011::0,0,255 sep 2011::0,0,255 oct 2011::0,0,221 nov 2011::0,0,255 dec 2011::63,0,255 jan 2010::0,0,221 feb 2010::0,0,255 mar 2010::0,0,255 apr 2010::63,0,255 may 2010::53,0,221 jun 2010::0,0,221 jul 2010::0,0,221 aug 2010::0,44,221 sep 2010::0,0,255 oct 2010::0,0,221 nov 2010::63,0,255 dec2010::0,0,255 1

  • jan 2013::0,0,255
  • feb 2013::63,0,255
  • mar 2013::63,0,255
  • apr 2013::63,0,255
  • may 2013::63,0,255
  • jun 2013::63,0,255
  • jul 2013::63,0,255
  • aug 2013::63,0,255
  • sep 2013::63,0,255
  • oct 2013::63,0,255
  • nov 2013::63,0,255
  • dec 2013::63,0,255
  • jan 2012::63,0,255
  • feb 2012::63,0,255
  • mar 2012::0,0,255
  • apr 2012::53,0,221
  • may 2012::0,0,255
  • jun 2012::63,0,255
  • jul 2012::0,0,221
  • aug 2012::63,0,255
  • sept 2012::63,0,255
  • oct 2012::53,0,221
  • nov 2012::53,0,221
  • dec 2012::63,0,255
  • jan 2011::0,0,221
  • feb 2011::63,0,255
  • mar 2011::53,0,221
  • apr 2011::53,0,221
  • may 2011::0,0,221
  • apr 2011::0,0,255
  • may 2011::53,0,221
  • jun 2011::53,0,221
  • jul 2011::53,0,221
  • aug 2011::0,0,255
  • sep 2011::0,0,255
  • oct 2011::0,0,221
  • nov 2011::0,0,255
  • dec 2011::63,0,255
  • jan 2010::0,0,221
  • feb 2010::0,0,255
  • mar 2010::0,0,255
  • apr 2010::63,0,255
  • may 2010::53,0,221
  • jun 2010::0,0,221
  • jul 2010::0,0,221
  • aug 2010::0,44,221
  • sep 2010::0,0,255
  • oct 2010::0,0,221
  • nov 2010::63,0,255
  • dec2010::0,0,255
  • 1

• Does the site have a Fire Alarm System

  Yes

  No

  N/A

• Does the site have an Early Warning Intercommunication System (EWIS)

  Yes

  No

  N/A

• Add media

  Media

Automatic Fire Sprinkler System Pump

• Is the automatic fire sprinkler system pump maintained by Centre Management?

  Yes

  No

  N/A

• Within PM test date

  Yes

  No

  N/A

• Date last tested

  Select jan 2013::0,0,255 feb 2013::63,0,255 mar 2013::63,0,255 apr 2013::63,0,255 may 2013::63,0,255 jun 2013::63,0,255 jul 2013::63,0,255 aug 2013::63,0,255 sep 2013::63,0,255 oct 2013::63,0,255 nov 2013::63,0,255 dec 2013::63,0,255 jan 2012::63,0,255 feb 2012::63,0,255 mar 2012::0,0,255 apr 2012::53,0,221 may 2012::0,0,255 jun 2012::63,0,255 jul 2012::0,0,221 aug 2012::63,0,255 sept 2012::63,0,255 oct 2012::53,0,221 nov 2012::53,0,221 dec 2012::63,0,255 jan 2011::0,0,221 feb 2011::63,0,255 mar 2011::53,0,221 apr 2011::53,0,221 may 2011::0,0,221 apr 2011::0,0,255 may 2011::53,0,221 jun 2011::53,0,221 jul 2011::53,0,221 aug 2011::0,0,255 sep 2011::0,0,255 oct 2011::0,0,221 nov 2011::0,0,255 dec 2011::63,0,255 jan 2010::0,0,221 feb 2010::0,0,255 mar 2010::0,0,255 apr 2010::63,0,255 may 2010::53,0,221 jun 2010::0,0,221 jul 2010::0,0,221 aug 2010::0,44,221 sep 2010::0,0,255 oct 2010::0,0,221 nov 2010::63,0,255 dec2010::0,0,255 1

  • jan 2013::0,0,255
  • feb 2013::63,0,255
  • mar 2013::63,0,255
  • apr 2013::63,0,255
  • may 2013::63,0,255
  • jun 2013::63,0,255
  • jul 2013::63,0,255
  • aug 2013::63,0,255
  • sep 2013::63,0,255
  • oct 2013::63,0,255
  • nov 2013::63,0,255
  • dec 2013::63,0,255
  • jan 2012::63,0,255
  • feb 2012::63,0,255
  • mar 2012::0,0,255
  • apr 2012::53,0,221
  • may 2012::0,0,255
  • jun 2012::63,0,255
  • jul 2012::0,0,221
  • aug 2012::63,0,255
  • sept 2012::63,0,255
  • oct 2012::53,0,221
  • nov 2012::53,0,221
  • dec 2012::63,0,255
  • jan 2011::0,0,221
  • feb 2011::63,0,255
  • mar 2011::53,0,221
  • apr 2011::53,0,221
  • may 2011::0,0,221
  • apr 2011::0,0,255
  • may 2011::53,0,221
  • jun 2011::53,0,221
  • jul 2011::53,0,221
  • aug 2011::0,0,255
  • sep 2011::0,0,255
  • oct 2011::0,0,221
  • nov 2011::0,0,255
  • dec 2011::63,0,255
  • jan 2010::0,0,221
  • feb 2010::0,0,255
  • mar 2010::0,0,255
  • apr 2010::63,0,255
  • may 2010::53,0,221
  • jun 2010::0,0,221
  • jul 2010::0,0,221
  • aug 2010::0,44,221
  • sep 2010::0,0,255
  • oct 2010::0,0,221
  • nov 2010::63,0,255
  • dec2010::0,0,255
  • 1

• Is there 500mm clearance to fire sprinkler heads?

  Yes

  No

  N/A

• Does the site have a Fire Sprinkler System

  Yes

  No

  N/A

• Does the site have Smoke curtain(s)

  Yes

  No

  N/A

• Add media

  Media

Electrical

• Residual Current Devices (RCD's)?

  Yes

  No

  N/A

• Has electrical equipment and Residual Current Devices been tested / tagged in last 12 months?

  Yes

  No

  N/A

• Within the Test Date?

  Select jan 2013::0,0,255 feb 2013::63,0,255 mar 2013::63,0,255 apr 2013::63,0,255 may 2013::63,0,255 jun 2013::63,0,255 jul 2013::63,0,255 aug 2013::63,0,255 sep 2013::63,0,255 oct 2013::63,0,255 nov 2013::63,0,255 dec 2013::63,0,255 jan 2012::63,0,255 feb 2012::63,0,255 mar 2012::0,0,255 apr 2012::53,0,221 may 2012::0,0,255 jun 2012::63,0,255 jul 2012::0,0,221 aug 2012::63,0,255 sept 2012::63,0,255 oct 2012::53,0,221 nov 2012::53,0,221 dec 2012::63,0,255 jan 2011::0,0,221 feb 2011::63,0,255 mar 2011::53,0,221 apr 2011::53,0,221 may 2011::0,0,221 apr 2011::0,0,255 may 2011::53,0,221 jun 2011::53,0,221 jul 2011::53,0,221 aug 2011::0,0,255 sep 2011::0,0,255 oct 2011::0,0,221 nov 2011::0,0,255 dec 2011::63,0,255 jan 2010::0,0,221 feb 2010::0,0,255 mar 2010::0,0,255 apr 2010::63,0,255 may 2010::53,0,221 jun 2010::0,0,221 jul 2010::0,0,221 aug 2010::0,44,221 sep 2010::0,0,255 oct 2010::0,0,221 nov 2010::63,0,255 dec2010::0,0,255 1

  • jan 2013::0,0,255
  • feb 2013::63,0,255
  • mar 2013::63,0,255
  • apr 2013::63,0,255
  • may 2013::63,0,255
  • jun 2013::63,0,255
  • jul 2013::63,0,255
  • aug 2013::63,0,255
  • sep 2013::63,0,255
  • oct 2013::63,0,255
  • nov 2013::63,0,255
  • dec 2013::63,0,255
  • jan 2012::63,0,255
  • feb 2012::63,0,255
  • mar 2012::0,0,255
  • apr 2012::53,0,221
  • may 2012::0,0,255
  • jun 2012::63,0,255
  • jul 2012::0,0,221
  • aug 2012::63,0,255
  • sept 2012::63,0,255
  • oct 2012::53,0,221
  • nov 2012::53,0,221
  • dec 2012::63,0,255
  • jan 2011::0,0,221
  • feb 2011::63,0,255
  • mar 2011::53,0,221
  • apr 2011::53,0,221
  • may 2011::0,0,221
  • apr 2011::0,0,255
  • may 2011::53,0,221
  • jun 2011::53,0,221
  • jul 2011::53,0,221
  • aug 2011::0,0,255
  • sep 2011::0,0,255
  • oct 2011::0,0,221
  • nov 2011::0,0,255
  • dec 2011::63,0,255
  • jan 2010::0,0,221
  • feb 2010::0,0,255
  • mar 2010::0,0,255
  • apr 2010::63,0,255
  • may 2010::53,0,221
  • jun 2010::0,0,221
  • jul 2010::0,0,221
  • aug 2010::0,44,221
  • sep 2010::0,0,255
  • oct 2010::0,0,221
  • nov 2010::63,0,255
  • dec2010::0,0,255
  • 1

• Are records available?

  select your response:1:230,230,230

  yes :0:230,230,230

  no:1:230,230,230

  n/a:1:230,230,230

  1

• Switchboards legends in place and are there any that require attention?

  Yes

  No

  N/A

• Have Distribution Board/ s had thermal test done in last 12 months.

  Yes

  No

  N/A

• Add media

  Media

Switches and Plugs

• Sample power points and leads inspected in good condition?

  Yes

  No

  N/A

• How many we're inspected?

  Select 1::255,255,255 2::255,255,255 3::255,255,255 4::255,255,255 5::255,255,255 6::255,255,255 7::255,255,255 8::255,255,255 9::255,255,255 10::255,255,255 ::255,255,255 1

  • 1::255,255,255
  • 2::255,255,255
  • 3::255,255,255
  • 4::255,255,255
  • 5::255,255,255
  • 6::255,255,255
  • 7::255,255,255
  • 8::255,255,255
  • 9::255,255,255
  • 10::255,255,255
  • ::255,255,255
  • 1

• Are power points being used appropriately (i.e no multiboards, double adaptors, etc)?

  Yes

  No

  N/A

• Add media

  Media

Electrical Test and Tag

• Record of inspection and testing on site?

  Yes

  No

  N/A

• Within PM test date?

  Yes

  No

  N/A

• Date last tested

  Select jan 2013::0,0,255 feb 2013::63,0,255 mar 2013::63,0,255 apr 2013::63,0,255 may 2013::63,0,255 jun 2013::63,0,255 jul 2013::63,0,255 aug 2013::63,0,255 sep 2013::63,0,255 oct 2013::63,0,255 nov 2013::63,0,255 dec 2013::63,0,255 jan 2012::63,0,255 feb 2012::63,0,255 mar 2012::0,0,255 apr 2012::53,0,221 may 2012::0,0,255 jun 2012::63,0,255 jul 2012::0,0,221 aug 2012::63,0,255 sept 2012::63,0,255 oct 2012::53,0,221 nov 2012::53,0,221 dec 2012::63,0,255 jan 2011::0,0,221 feb 2011::63,0,255 mar 2011::53,0,221 apr 2011::53,0,221 may 2011::0,0,221 apr 2011::0,0,255 may 2011::53,0,221 jun 2011::53,0,221 jul 2011::53,0,221 aug 2011::0,0,255 sep 2011::0,0,255 oct 2011::0,0,221 nov 2011::0,0,255 dec 2011::63,0,255 jan 2010::0,0,221 feb 2010::0,0,255 mar 2010::0,0,255 apr 2010::63,0,255 may 2010::53,0,221 jun 2010::0,0,221 jul 2010::0,0,221 aug 2010::0,44,221 sep 2010::0,0,255 oct 2010::0,0,221 nov 2010::63,0,255 dec2010::0,0,255 1

  • jan 2013::0,0,255
  • feb 2013::63,0,255
  • mar 2013::63,0,255
  • apr 2013::63,0,255
  • may 2013::63,0,255
  • jun 2013::63,0,255
  • jul 2013::63,0,255
  • aug 2013::63,0,255
  • sep 2013::63,0,255
  • oct 2013::63,0,255
  • nov 2013::63,0,255
  • dec 2013::63,0,255
  • jan 2012::63,0,255
  • feb 2012::63,0,255
  • mar 2012::0,0,255
  • apr 2012::53,0,221
  • may 2012::0,0,255
  • jun 2012::63,0,255
  • jul 2012::0,0,221
  • aug 2012::63,0,255
  • sept 2012::63,0,255
  • oct 2012::53,0,221
  • nov 2012::53,0,221
  • dec 2012::63,0,255
  • jan 2011::0,0,221
  • feb 2011::63,0,255
  • mar 2011::53,0,221
  • apr 2011::53,0,221
  • may 2011::0,0,221
  • apr 2011::0,0,255
  • may 2011::53,0,221
  • jun 2011::53,0,221
  • jul 2011::53,0,221
  • aug 2011::0,0,255
  • sep 2011::0,0,255
  • oct 2011::0,0,221
  • nov 2011::0,0,255
  • dec 2011::63,0,255
  • jan 2010::0,0,221
  • feb 2010::0,0,255
  • mar 2010::0,0,255
  • apr 2010::63,0,255
  • may 2010::53,0,221
  • jun 2010::0,0,221
  • jul 2010::0,0,221
  • aug 2010::0,44,221
  • sep 2010::0,0,255
  • oct 2010::0,0,221
  • nov 2010::63,0,255
  • dec2010::0,0,255
  • 1

• All tags affixed to units / assets?

  Yes

  No

  N/A

• Add media

  Media

Emergency Lighting and Illuminated Exit Signs

• All units operating as required?

  Yes

  No

  N/A

• Record of Inspection and Testing on site?

  Yes

  No

  N/A

• Within PM test date?

  Yes

  No

  N/A

• Date last tested

  Select jan 2013::0,0,255 feb 2013::63,0,255 mar 2013::63,0,255 apr 2013::63,0,255 may 2013::63,0,255 jun 2013::63,0,255 jul 2013::63,0,255 aug 2013::63,0,255 sep 2013::63,0,255 oct 2013::63,0,255 nov 2013::63,0,255 dec 2013::63,0,255 jan 2012::63,0,255 feb 2012::63,0,255 mar 2012::0,0,255 apr 2012::53,0,221 may 2012::0,0,255 jun 2012::63,0,255 jul 2012::0,0,221 aug 2012::63,0,255 sept 2012::63,0,255 oct 2012::53,0,221 nov 2012::53,0,221 dec 2012::63,0,255 jan 2011::0,0,221 feb 2011::63,0,255 mar 2011::53,0,221 apr 2011::53,0,221 may 2011::0,0,221 apr 2011::0,0,255 may 2011::53,0,221 jun 2011::53,0,221 jul 2011::53,0,221 aug 2011::0,0,255 sep 2011::0,0,255 oct 2011::0,0,221 nov 2011::0,0,255 dec 2011::63,0,255 jan 2010::0,0,221 feb 2010::0,0,255 mar 2010::0,0,255 apr 2010::63,0,255 may 2010::53,0,221 jun 2010::0,0,221 jul 2010::0,0,221 aug 2010::0,44,221 sep 2010::0,0,255 oct 2010::0,0,221 nov 2010::63,0,255 dec2010::0,0,255 1

  • jan 2013::0,0,255
  • feb 2013::63,0,255
  • mar 2013::63,0,255
  • apr 2013::63,0,255
  • may 2013::63,0,255
  • jun 2013::63,0,255
  • jul 2013::63,0,255
  • aug 2013::63,0,255
  • sep 2013::63,0,255
  • oct 2013::63,0,255
  • nov 2013::63,0,255
  • dec 2013::63,0,255
  • jan 2012::63,0,255
  • feb 2012::63,0,255
  • mar 2012::0,0,255
  • apr 2012::53,0,221
  • may 2012::0,0,255
  • jun 2012::63,0,255
  • jul 2012::0,0,221
  • aug 2012::63,0,255
  • sept 2012::63,0,255
  • oct 2012::53,0,221
  • nov 2012::53,0,221
  • dec 2012::63,0,255
  • jan 2011::0,0,221
  • feb 2011::63,0,255
  • mar 2011::53,0,221
  • apr 2011::53,0,221
  • may 2011::0,0,221
  • apr 2011::0,0,255
  • may 2011::53,0,221
  • jun 2011::53,0,221
  • jul 2011::53,0,221
  • aug 2011::0,0,255
  • sep 2011::0,0,255
  • oct 2011::0,0,221
  • nov 2011::0,0,255
  • dec 2011::63,0,255
  • jan 2010::0,0,221
  • feb 2010::0,0,255
  • mar 2010::0,0,255
  • apr 2010::63,0,255
  • may 2010::53,0,221
  • jun 2010::0,0,221
  • jul 2010::0,0,221
  • aug 2010::0,44,221
  • sep 2010::0,0,255
  • oct 2010::0,0,221
  • nov 2010::63,0,255
  • dec2010::0,0,255
  • 1

• Add media

  Media

Hazardous Substances

• Is Hazmat register current?

  Yes

  No

  N/A

• Are there any hazardous materials or dangerous goods present on site?

  Yes

  No

  N/A

• Are the materials or goods stored correctly?

  Yes

  No

  N/A

• Are Material Safety Data Sheets (MSDS) available for all dangerous goods?

  Yes

  No

  N/A

• Is there asbestos on site and is the register up to date?

  Yes

  No

  N/A

• Re-inspection of Asbestos completed?

  Yes

  No

  N/A

• Date Asbestos Re inspection completed?

  Select jan 2013::0,0,255 feb 2013::63,0,255 mar 2013::63,0,255 apr 2013::63,0,255 may 2013::63,0,255 jun 2013::63,0,255 jul 2013::63,0,255 aug 2013::63,0,255 sep 2013::63,0,255 oct 2013::63,0,255 nov 2013::63,0,255 dec 2013::63,0,255 jan 2012::63,0,255 feb 2012::63,0,255 mar 2012::0,0,255 apr 2012::53,0,221 may 2012::0,0,255 jun 2012::63,0,255 jul 2012::0,0,221 aug 2012::63,0,255 sept 2012::63,0,255 oct 2012::53,0,221 nov 2012::53,0,221 dec 2012::63,0,255 jan 2011::0,0,221 feb 2011::63,0,255 mar 2011::53,0,221 apr 2011::53,0,221 may 2011::0,0,221 apr 2011::0,0,255 may 2011::53,0,221 jun 2011::53,0,221 jul 2011::53,0,221 aug 2011::0,0,255 sep 2011::0,0,255 oct 2011::0,0,221 nov 2011::0,0,255 dec 2011::63,0,255 jan 2010::0,0,221 feb 2010::0,0,255 mar 2010::0,0,255 apr 2010::63,0,255 may 2010::53,0,221 jun 2010::0,0,221 jul 2010::0,0,221 aug 2010::0,44,221 sep 2010::0,0,255 oct 2010::0,0,221 nov 2010::63,0,255 dec2010::0,0,255 1

  • jan 2013::0,0,255
  • feb 2013::63,0,255
  • mar 2013::63,0,255
  • apr 2013::63,0,255
  • may 2013::63,0,255
  • jun 2013::63,0,255
  • jul 2013::63,0,255
  • aug 2013::63,0,255
  • sep 2013::63,0,255
  • oct 2013::63,0,255
  • nov 2013::63,0,255
  • dec 2013::63,0,255
  • jan 2012::63,0,255
  • feb 2012::63,0,255
  • mar 2012::0,0,255
  • apr 2012::53,0,221
  • may 2012::0,0,255
  • jun 2012::63,0,255
  • jul 2012::0,0,221
  • aug 2012::63,0,255
  • sept 2012::63,0,255
  • oct 2012::53,0,221
  • nov 2012::53,0,221
  • dec 2012::63,0,255
  • jan 2011::0,0,221
  • feb 2011::63,0,255
  • mar 2011::53,0,221
  • apr 2011::53,0,221
  • may 2011::0,0,221
  • apr 2011::0,0,255
  • may 2011::53,0,221
  • jun 2011::53,0,221
  • jul 2011::53,0,221
  • aug 2011::0,0,255
  • sep 2011::0,0,255
  • oct 2011::0,0,221
  • nov 2011::0,0,255
  • dec 2011::63,0,255
  • jan 2010::0,0,221
  • feb 2010::0,0,255
  • mar 2010::0,0,255
  • apr 2010::63,0,255
  • may 2010::53,0,221
  • jun 2010::0,0,221
  • jul 2010::0,0,221
  • aug 2010::0,44,221
  • sep 2010::0,0,255
  • oct 2010::0,0,221
  • nov 2010::63,0,255
  • dec2010::0,0,255
  • 1

• Is a spill kit on site and is it complete?

  Yes

  No

  N/A

• Add media

  Media

• Add media

  Media

Interior Environment

• Are floors and surfaces in good condition?

  Yes

  No

  N/A

• Are stairways and aisles kept clear and useable?

  Yes

  No

  N/A

• Are lighting levels satisfactory?

  Yes

  No

  N/A

• Is the general presentation and cleanliness satisfactory? Eg floors to Company standards?

  Yes

  No

  N/A

• Is CCTV operational?

  Yes

  No

  N/A

• Are shop fronts clean / presentable?

  Yes

  No

  N/A

• Are interior signs in good condition and if electrical illuminated?

  Yes

  No

  N/A

• Add media

  Media

• Add media

  Media

Exterior Environment

• Are exterior walls and surfaces clean and in good repair?

  Yes

  No

  N/A

• Are paths and external stairs in good condition?

  Yes

  No

  N/A

• Are roller doors / boom gates / dock levellers operational / undamaged?

  Yes

  No

  N/A

• Is exterior / security lighting working?

  Yes

  No

  N/A

• Are drains / grates clear of rubbish?

  Yes

  No

  N/A

• Are landscaped areas well presented & free from rubbish?

  Yes

  No

  N/A

• Add media

  Media

• Add media

  Media

Car Park

• Is car park surface in good condition?

  Yes

  No

  N/A

• Are parking areas tidy and bollards/speed humps undamaged?

  Yes

  No

  N/A

• Is the line marking & signage adequate in the car park area?

  Yes

  No

  N/A

• Is car park lighting sufficient and timers working?

  Yes

  No

  N/A

• Add media

  Media

Plant Rooms

• Does the site have a plant room?

  Yes

  No

  N/A

• Are ALL plant rooms neat and tidy, free from debris and trip hazards?

  Yes

  No

  N/A

• Pressure vessel testing within PM test date?

  Yes

  No

  N/A

• Date last tested

  Select jan 2013::0,0,255 feb 2013::63,0,255 mar 2013::63,0,255 apr 2013::63,0,255 may 2013::63,0,255 jun 2013::63,0,255 jul 2013::63,0,255 aug 2013::63,0,255 sep 2013::63,0,255 oct 2013::63,0,255 nov 2013::63,0,255 dec 2013::63,0,255 jan 2012::63,0,255 feb 2012::63,0,255 mar 2012::0,0,255 apr 2012::53,0,221 may 2012::0,0,255 jun 2012::63,0,255 jul 2012::0,0,221 aug 2012::63,0,255 sept 2012::63,0,255 oct 2012::53,0,221 nov 2012::53,0,221 dec 2012::63,0,255 jan 2011::0,0,221 feb 2011::63,0,255 mar 2011::53,0,221 apr 2011::53,0,221 may 2011::0,0,221 apr 2011::0,0,255 may 2011::53,0,221 jun 2011::53,0,221 jul 2011::53,0,221 aug 2011::0,0,255 sep 2011::0,0,255 oct 2011::0,0,221 nov 2011::0,0,255 dec 2011::63,0,255 jan 2010::0,0,221 feb 2010::0,0,255 mar 2010::0,0,255 apr 2010::63,0,255 may 2010::53,0,221 jun 2010::0,0,221 jul 2010::0,0,221 aug 2010::0,44,221 sep 2010::0,0,255 oct 2010::0,0,221 nov 2010::63,0,255 dec2010::0,0,255 1

  • jan 2013::0,0,255
  • feb 2013::63,0,255
  • mar 2013::63,0,255
  • apr 2013::63,0,255
  • may 2013::63,0,255
  • jun 2013::63,0,255
  • jul 2013::63,0,255
  • aug 2013::63,0,255
  • sep 2013::63,0,255
  • oct 2013::63,0,255
  • nov 2013::63,0,255
  • dec 2013::63,0,255
  • jan 2012::63,0,255
  • feb 2012::63,0,255
  • mar 2012::0,0,255
  • apr 2012::53,0,221
  • may 2012::0,0,255
  • jun 2012::63,0,255
  • jul 2012::0,0,221
  • aug 2012::63,0,255
  • sept 2012::63,0,255
  • oct 2012::53,0,221
  • nov 2012::53,0,221
  • dec 2012::63,0,255
  • jan 2011::0,0,221
  • feb 2011::63,0,255
  • mar 2011::53,0,221
  • apr 2011::53,0,221
  • may 2011::0,0,221
  • apr 2011::0,0,255
  • may 2011::53,0,221
  • jun 2011::53,0,221
  • jul 2011::53,0,221
  • aug 2011::0,0,255
  • sep 2011::0,0,255
  • oct 2011::0,0,221
  • nov 2011::0,0,255
  • dec 2011::63,0,255
  • jan 2010::0,0,221
  • feb 2010::0,0,255
  • mar 2010::0,0,255
  • apr 2010::63,0,255
  • may 2010::53,0,221
  • jun 2010::0,0,221
  • jul 2010::0,0,221
  • aug 2010::0,44,221
  • sep 2010::0,0,255
  • oct 2010::0,0,221
  • nov 2010::63,0,255
  • dec2010::0,0,255
  • 1

• Pressure vessel registration displayed?

  Yes

  No

  N/A

• Registered until

  Select jan 2013::0,0,255 feb 2013::63,0,255 mar 2013::63,0,255 apr 2013::63,0,255 may 2013::63,0,255 jun 2013::63,0,255 jul 2013::63,0,255 aug 2013::63,0,255 sep 2013::63,0,255 oct 2013::63,0,255 nov 2013::63,0,255 dec 2013::63,0,255 jan 2012::63,0,255 feb 2012::63,0,255 mar 2012::0,0,255 apr 2012::53,0,221 may 2012::0,0,255 jun 2012::63,0,255 jul 2012::0,0,221 aug 2012::63,0,255 sept 2012::63,0,255 oct 2012::53,0,221 nov 2012::53,0,221 dec 2012::63,0,255 jan 2011::0,0,221 feb 2011::63,0,255 mar 2011::53,0,221 apr 2011::53,0,221 may 2011::0,0,221 apr 2011::0,0,255 may 2011::53,0,221 jun 2011::53,0,221 jul 2011::53,0,221 aug 2011::0,0,255 sep 2011::0,0,255 oct 2011::0,0,221 nov 2011::0,0,255 dec 2011::63,0,255 jan 2010::0,0,221 feb 2010::0,0,255 mar 2010::0,0,255 apr 2010::63,0,255 may 2010::53,0,221 jun 2010::0,0,221 jul 2010::0,0,221 aug 2010::0,44,221 sep 2010::0,0,255 oct 2010::0,0,221 nov 2010::63,0,255 dec2010::0,0,255 1

  • jan 2013::0,0,255
  • feb 2013::63,0,255
  • mar 2013::63,0,255
  • apr 2013::63,0,255
  • may 2013::63,0,255
  • jun 2013::63,0,255
  • jul 2013::63,0,255
  • aug 2013::63,0,255
  • sep 2013::63,0,255
  • oct 2013::63,0,255
  • nov 2013::63,0,255
  • dec 2013::63,0,255
  • jan 2012::63,0,255
  • feb 2012::63,0,255
  • mar 2012::0,0,255
  • apr 2012::53,0,221
  • may 2012::0,0,255
  • jun 2012::63,0,255
  • jul 2012::0,0,221
  • aug 2012::63,0,255
  • sept 2012::63,0,255
  • oct 2012::53,0,221
  • nov 2012::53,0,221
  • dec 2012::63,0,255
  • jan 2011::0,0,221
  • feb 2011::63,0,255
  • mar 2011::53,0,221
  • apr 2011::53,0,221
  • may 2011::0,0,221
  • apr 2011::0,0,255
  • may 2011::53,0,221
  • jun 2011::53,0,221
  • jul 2011::53,0,221
  • aug 2011::0,0,255
  • sep 2011::0,0,255
  • oct 2011::0,0,221
  • nov 2011::0,0,255
  • dec 2011::63,0,255
  • jan 2010::0,0,221
  • feb 2010::0,0,255
  • mar 2010::0,0,255
  • apr 2010::63,0,255
  • may 2010::53,0,221
  • jun 2010::0,0,221
  • jul 2010::0,0,221
  • aug 2010::0,44,221
  • sep 2010::0,0,255
  • oct 2010::0,0,221
  • nov 2010::63,0,255
  • dec2010::0,0,255
  • 1

• Are all access ladders and stairways in good condition?

  Yes

  No

  N/A

• Add media

  Media

Standby Generator

• Does the site have a standby generator?

  select your response:1:230,230,230

  yes :0:230,230,230

  no:1:230,230,230

  n/a:1:230,230,230

  1

• Is there a test log in place?

  Yes

  No

  N/A

• Date last tested

  Select jan 2013::0,0,255 feb 2013::63,0,255 mar 2013::63,0,255 apr 2013::63,0,255 may 2013::63,0,255 jun 2013::63,0,255 jul 2013::63,0,255 aug 2013::63,0,255 sep 2013::63,0,255 oct 2013::63,0,255 nov 2013::63,0,255 dec 2013::63,0,255 jan 2012::63,0,255 feb 2012::63,0,255 mar 2012::0,0,255 apr 2012::53,0,221 may 2012::0,0,255 jun 2012::63,0,255 jul 2012::0,0,221 aug 2012::63,0,255 sept 2012::63,0,255 oct 2012::53,0,221 nov 2012::53,0,221 dec 2012::63,0,255 jan 2011::0,0,221 feb 2011::63,0,255 mar 2011::53,0,221 apr 2011::53,0,221 may 2011::0,0,221 apr 2011::0,0,255 may 2011::53,0,221 jun 2011::53,0,221 jul 2011::53,0,221 aug 2011::0,0,255 sep 2011::0,0,255 oct 2011::0,0,221 nov 2011::0,0,255 dec 2011::63,0,255 jan 2010::0,0,221 feb 2010::0,0,255 mar 2010::0,0,255 apr 2010::63,0,255 may 2010::53,0,221 jun 2010::0,0,221 jul 2010::0,0,221 aug 2010::0,44,221 sep 2010::0,0,255 oct 2010::0,0,221 nov 2010::63,0,255 dec2010::0,0,255 1

  • jan 2013::0,0,255
  • feb 2013::63,0,255
  • mar 2013::63,0,255
  • apr 2013::63,0,255
  • may 2013::63,0,255
  • jun 2013::63,0,255
  • jul 2013::63,0,255
  • aug 2013::63,0,255
  • sep 2013::63,0,255
  • oct 2013::63,0,255
  • nov 2013::63,0,255
  • dec 2013::63,0,255
  • jan 2012::63,0,255
  • feb 2012::63,0,255
  • mar 2012::0,0,255
  • apr 2012::53,0,221
  • may 2012::0,0,255
  • jun 2012::63,0,255
  • jul 2012::0,0,221
  • aug 2012::63,0,255
  • sept 2012::63,0,255
  • oct 2012::53,0,221
  • nov 2012::53,0,221
  • dec 2012::63,0,255
  • jan 2011::0,0,221
  • feb 2011::63,0,255
  • mar 2011::53,0,221
  • apr 2011::53,0,221
  • may 2011::0,0,221
  • apr 2011::0,0,255
  • may 2011::53,0,221
  • jun 2011::53,0,221
  • jul 2011::53,0,221
  • aug 2011::0,0,255
  • sep 2011::0,0,255
  • oct 2011::0,0,221
  • nov 2011::0,0,255
  • dec 2011::63,0,255
  • jan 2010::0,0,221
  • feb 2010::0,0,255
  • mar 2010::0,0,255
  • apr 2010::63,0,255
  • may 2010::53,0,221
  • jun 2010::0,0,221
  • jul 2010::0,0,221
  • aug 2010::0,44,221
  • sep 2010::0,0,255
  • oct 2010::0,0,221
  • nov 2010::63,0,255
  • dec2010::0,0,255
  • 1

• Is the Generator fuel level full?

  Yes

  No

  N/A

• Is the correct diesel signage on the Jerry can?

  Yes

  No

  N/A

• Is the Generator area clear and is there adequate air flow?

  Yes

  No

  N/A

• Add media

  Media

Plant Room Lifting Winch, and Safety

• Does the Store have a lifting winch?

  Yes

  No

  N/A

• Does the Store need a lifting winch?

  Yes

  No

  N/A

• Type in further information here......

• Is the wire rope and unit in good condition?

  Yes

  No

  N/A

• Has the Jib crane been serviced?

  Yes

  No

  N/A

• Is the certification stamp in place?

  Yes

  No

  N/A

• Date last tested

  Select jan 2013::0,0,255 feb 2013::63,0,255 mar 2013::63,0,255 apr 2013::63,0,255 may 2013::63,0,255 jun 2013::63,0,255 jul 2013::63,0,255 aug 2013::63,0,255 sep 2013::63,0,255 oct 2013::63,0,255 nov 2013::63,0,255 dec 2013::63,0,255 jan 2012::63,0,255 feb 2012::63,0,255 mar 2012::0,0,255 apr 2012::53,0,221 may 2012::0,0,255 jun 2012::63,0,255 jul 2012::0,0,221 aug 2012::63,0,255 sept 2012::63,0,255 oct 2012::53,0,221 nov 2012::53,0,221 dec 2012::63,0,255 jan 2011::0,0,221 feb 2011::63,0,255 mar 2011::53,0,221 apr 2011::53,0,221 may 2011::0,0,221 apr 2011::0,0,255 may 2011::53,0,221 jun 2011::53,0,221 jul 2011::53,0,221 aug 2011::0,0,255 sep 2011::0,0,255 oct 2011::0,0,221 nov 2011::0,0,255 dec 2011::63,0,255 jan 2010::0,0,221 feb 2010::0,0,255 mar 2010::0,0,255 apr 2010::63,0,255 may 2010::53,0,221 jun 2010::0,0,221 jul 2010::0,0,221 aug 2010::0,44,221 sep 2010::0,0,255 oct 2010::0,0,221 nov 2010::63,0,255 dec2010::0,0,255 1

  • jan 2013::0,0,255
  • feb 2013::63,0,255
  • mar 2013::63,0,255
  • apr 2013::63,0,255
  • may 2013::63,0,255
  • jun 2013::63,0,255
  • jul 2013::63,0,255
  • aug 2013::63,0,255
  • sep 2013::63,0,255
  • oct 2013::63,0,255
  • nov 2013::63,0,255
  • dec 2013::63,0,255
  • jan 2012::63,0,255
  • feb 2012::63,0,255
  • mar 2012::0,0,255
  • apr 2012::53,0,221
  • may 2012::0,0,255
  • jun 2012::63,0,255
  • jul 2012::0,0,221
  • aug 2012::63,0,255
  • sept 2012::63,0,255
  • oct 2012::53,0,221
  • nov 2012::53,0,221
  • dec 2012::63,0,255
  • jan 2011::0,0,221
  • feb 2011::63,0,255
  • mar 2011::53,0,221
  • apr 2011::53,0,221
  • may 2011::0,0,221
  • apr 2011::0,0,255
  • may 2011::53,0,221
  • jun 2011::53,0,221
  • jul 2011::53,0,221
  • aug 2011::0,0,255
  • sep 2011::0,0,255
  • oct 2011::0,0,221
  • nov 2011::0,0,255
  • dec 2011::63,0,255
  • jan 2010::0,0,221
  • feb 2010::0,0,255
  • mar 2010::0,0,255
  • apr 2010::63,0,255
  • may 2010::53,0,221
  • jun 2010::0,0,221
  • jul 2010::0,0,221
  • aug 2010::0,44,221
  • sep 2010::0,0,255
  • oct 2010::0,0,221
  • nov 2010::63,0,255
  • dec2010::0,0,255
  • 1

• Harness anchor points installed?

  Yes

  No

  N/A

• Date last tested

  Select jan 2013::0,0,255 feb 2013::63,0,255 mar 2013::63,0,255 apr 2013::63,0,255 may 2013::63,0,255 jun 2013::63,0,255 jul 2013::63,0,255 aug 2013::63,0,255 sep 2013::63,0,255 oct 2013::63,0,255 nov 2013::63,0,255 dec 2013::63,0,255 jan 2012::63,0,255 feb 2012::63,0,255 mar 2012::0,0,255 apr 2012::53,0,221 may 2012::0,0,255 jun 2012::63,0,255 jul 2012::0,0,221 aug 2012::63,0,255 sept 2012::63,0,255 oct 2012::53,0,221 nov 2012::53,0,221 dec 2012::63,0,255 jan 2011::0,0,221 feb 2011::63,0,255 mar 2011::53,0,221 apr 2011::53,0,221 may 2011::0,0,221 apr 2011::0,0,255 may 2011::53,0,221 jun 2011::53,0,221 jul 2011::53,0,221 aug 2011::0,0,255 sep 2011::0,0,255 oct 2011::0,0,221 nov 2011::0,0,255 dec 2011::63,0,255 jan 2010::0,0,221 feb 2010::0,0,255 mar 2010::0,0,255 apr 2010::63,0,255 may 2010::53,0,221 jun 2010::0,0,221 jul 2010::0,0,221 aug 2010::0,44,221 sep 2010::0,0,255 oct 2010::0,0,221 nov 2010::63,0,255 dec2010::0,0,255 1

  • jan 2013::0,0,255
  • feb 2013::63,0,255
  • mar 2013::63,0,255
  • apr 2013::63,0,255
  • may 2013::63,0,255
  • jun 2013::63,0,255
  • jul 2013::63,0,255
  • aug 2013::63,0,255
  • sep 2013::63,0,255
  • oct 2013::63,0,255
  • nov 2013::63,0,255
  • dec 2013::63,0,255
  • jan 2012::63,0,255
  • feb 2012::63,0,255
  • mar 2012::0,0,255
  • apr 2012::53,0,221
  • may 2012::0,0,255
  • jun 2012::63,0,255
  • jul 2012::0,0,221
  • aug 2012::63,0,255
  • sept 2012::63,0,255
  • oct 2012::53,0,221
  • nov 2012::53,0,221
  • dec 2012::63,0,255
  • jan 2011::0,0,221
  • feb 2011::63,0,255
  • mar 2011::53,0,221
  • apr 2011::53,0,221
  • may 2011::0,0,221
  • apr 2011::0,0,255
  • may 2011::53,0,221
  • jun 2011::53,0,221
  • jul 2011::53,0,221
  • aug 2011::0,0,255
  • sep 2011::0,0,255
  • oct 2011::0,0,221
  • nov 2011::0,0,255
  • dec 2011::63,0,255
  • jan 2010::0,0,221
  • feb 2010::0,0,255
  • mar 2010::0,0,255
  • apr 2010::63,0,255
  • may 2010::53,0,221
  • jun 2010::0,0,221
  • jul 2010::0,0,221
  • aug 2010::0,44,221
  • sep 2010::0,0,255
  • oct 2010::0,0,221
  • nov 2010::63,0,255
  • dec2010::0,0,255
  • 1

• Elevated equipment access door has fall protection?

  Yes

  No

  N/A

• Anchor point certification in place?

  Yes

  No

  N/A

• Height danger warning signage in place?

  Yes

  No

  N/A

• Add media

  Media

Roof and Height Safety

• Roofing sheets in good condition?

  Yes

  No

  N/A

• Are gutters and sumps clear and in good condition?

  Yes

  No

  N/A

• Is the roof area free from debris and trip hazards?

  Yes

  No

  N/A

• Is there a Roof / Gutter PM in place?

  Yes

  No

  N/A

• If a PM is required select the frequency

  Select select a response:1:230,230,230 weekly:1:230,230,230 fortnightly:0:230,230,230 monthly:1:230,230,230 3 monthly:1:230,230,230 6 monthly :1:230,230,230 yearly:1:230,230,230 1

  • select a response:1:230,230,230
  • weekly:1:230,230,230
  • fortnightly:0:230,230,230
  • monthly:1:230,230,230
  • 3 monthly:1:230,230,230
  • 6 monthly :1:230,230,230
  • yearly:1:230,230,230
  • 1

• Safety. Are roof walkways and perimeter barriers in good condition?

  Yes

  No

  N/A

• Safety. Is height safety equipment installed?

  Yes

  No

  N/A

• Safety. Are Active systems re- certified annually?

  Yes

  No

  N/A

• Date last tested

  Select jan 2013::0,0,255 feb 2013::63,0,255 mar 2013::63,0,255 apr 2013::63,0,255 may 2013::63,0,255 jun 2013::63,0,255 jul 2013::63,0,255 aug 2013::63,0,255 sep 2013::63,0,255 oct 2013::63,0,255 nov 2013::63,0,255 dec 2013::63,0,255 jan 2012::63,0,255 feb 2012::63,0,255 mar 2012::0,0,255 apr 2012::53,0,221 may 2012::0,0,255 jun 2012::63,0,255 jul 2012::0,0,221 aug 2012::63,0,255 sept 2012::63,0,255 oct 2012::53,0,221 nov 2012::53,0,221 dec 2012::63,0,255 jan 2011::0,0,221 feb 2011::63,0,255 mar 2011::53,0,221 apr 2011::53,0,221 may 2011::0,0,221 apr 2011::0,0,255 may 2011::53,0,221 jun 2011::53,0,221 jul 2011::53,0,221 aug 2011::0,0,255 sep 2011::0,0,255 oct 2011::0,0,221 nov 2011::0,0,255 dec 2011::63,0,255 jan 2010::0,0,221 feb 2010::0,0,255 mar 2010::0,0,255 apr 2010::63,0,255 may 2010::53,0,221 jun 2010::0,0,221 jul 2010::0,0,221 aug 2010::0,44,221 sep 2010::0,0,255 oct 2010::0,0,221 nov 2010::63,0,255 dec2010::0,0,255 1

  • jan 2013::0,0,255
  • feb 2013::63,0,255
  • mar 2013::63,0,255
  • apr 2013::63,0,255
  • may 2013::63,0,255
  • jun 2013::63,0,255
  • jul 2013::63,0,255
  • aug 2013::63,0,255
  • sep 2013::63,0,255
  • oct 2013::63,0,255
  • nov 2013::63,0,255
  • dec 2013::63,0,255
  • jan 2012::63,0,255
  • feb 2012::63,0,255
  • mar 2012::0,0,255
  • apr 2012::53,0,221
  • may 2012::0,0,255
  • jun 2012::63,0,255
  • jul 2012::0,0,221
  • aug 2012::63,0,255
  • sept 2012::63,0,255
  • oct 2012::53,0,221
  • nov 2012::53,0,221
  • dec 2012::63,0,255
  • jan 2011::0,0,221
  • feb 2011::63,0,255
  • mar 2011::53,0,221
  • apr 2011::53,0,221
  • may 2011::0,0,221
  • apr 2011::0,0,255
  • may 2011::53,0,221
  • jun 2011::53,0,221
  • jul 2011::53,0,221
  • aug 2011::0,0,255
  • sep 2011::0,0,255
  • oct 2011::0,0,221
  • nov 2011::0,0,255
  • dec 2011::63,0,255
  • jan 2010::0,0,221
  • feb 2010::0,0,255
  • mar 2010::0,0,255
  • apr 2010::63,0,255
  • may 2010::53,0,221
  • jun 2010::0,0,221
  • jul 2010::0,0,221
  • aug 2010::0,44,221
  • sep 2010::0,0,255
  • oct 2010::0,0,221
  • nov 2010::63,0,255
  • dec2010::0,0,255
  • 1

• Add media

  Media

Plumbing

• Has the back flow device been tested?

  Yes

  No

  N/A

• Are grease traps serviced as per regulations?

  Yes

  No

  N/A

• Are sump pumps operational and regularly serviced?

  Yes

  No

  N/A

• Add media

  Media

Refrigeration

• Site has refrigeration ?

  Yes

  No

  N/A

• Do any of the refrigerated cases have any water leaks?

  Yes

  No

  N/A

• Type in further information here......

• Plant Room. no oil leaks

  Yes

  No

  N/A

• Plant Room. Any loose brackets?

  Yes

  No

  N/A

• Plant Room.. Any excessive pipe vibration

  Yes

  No

  N/A

• Plant Room. Log books available and up to date?

  Yes

  No

  N/A

• Add media

  Media

Air Conditioning

• Is air conditioning within operational limits?

  Yes

  No

  N/A

• Is the site air - conditioned?

  Yes

  No

  N/A

• Is the air conditioning a Woolworths owned?

  Yes

  No

  N/A

• Is the air conditioning Shopping Centre / Landlord owned?

  Yes

  No

  N/A

• Is the air conditioning an evaporative system?

  Yes

  No

  N/A

• Plant Room. Are log books available for the monthly PM checks? And what was the last recorded date?

  Yes

  No

  N/A

• Date last tested

  Select jan 2013::0,0,255 feb 2013::63,0,255 mar 2013::63,0,255 apr 2013::63,0,255 may 2013::63,0,255 jun 2013::63,0,255 jul 2013::63,0,255 aug 2013::63,0,255 sep 2013::63,0,255 oct 2013::63,0,255 nov 2013::63,0,255 dec 2013::63,0,255 jan 2012::63,0,255 feb 2012::63,0,255 mar 2012::0,0,255 apr 2012::53,0,221 may 2012::0,0,255 jun 2012::63,0,255 jul 2012::0,0,221 aug 2012::63,0,255 sept 2012::63,0,255 oct 2012::53,0,221 nov 2012::53,0,221 dec 2012::63,0,255 jan 2011::0,0,221 feb 2011::63,0,255 mar 2011::53,0,221 apr 2011::53,0,221 may 2011::0,0,221 apr 2011::0,0,255 may 2011::53,0,221 jun 2011::53,0,221 jul 2011::53,0,221 aug 2011::0,0,255 sep 2011::0,0,255 oct 2011::0,0,221 nov 2011::0,0,255 dec 2011::63,0,255 jan 2010::0,0,221 feb 2010::0,0,255 mar 2010::0,0,255 apr 2010::63,0,255 may 2010::53,0,221 jun 2010::0,0,221 jul 2010::0,0,221 aug 2010::0,44,221 sep 2010::0,0,255 oct 2010::0,0,221 nov 2010::63,0,255 dec2010::0,0,255 1

  • jan 2013::0,0,255
  • feb 2013::63,0,255
  • mar 2013::63,0,255
  • apr 2013::63,0,255
  • may 2013::63,0,255
  • jun 2013::63,0,255
  • jul 2013::63,0,255
  • aug 2013::63,0,255
  • sep 2013::63,0,255
  • oct 2013::63,0,255
  • nov 2013::63,0,255
  • dec 2013::63,0,255
  • jan 2012::63,0,255
  • feb 2012::63,0,255
  • mar 2012::0,0,255
  • apr 2012::53,0,221
  • may 2012::0,0,255
  • jun 2012::63,0,255
  • jul 2012::0,0,221
  • aug 2012::63,0,255
  • sept 2012::63,0,255
  • oct 2012::53,0,221
  • nov 2012::53,0,221
  • dec 2012::63,0,255
  • jan 2011::0,0,221
  • feb 2011::63,0,255
  • mar 2011::53,0,221
  • apr 2011::53,0,221
  • may 2011::0,0,221
  • apr 2011::0,0,255
  • may 2011::53,0,221
  • jun 2011::53,0,221
  • jul 2011::53,0,221
  • aug 2011::0,0,255
  • sep 2011::0,0,255
  • oct 2011::0,0,221
  • nov 2011::0,0,255
  • dec 2011::63,0,255
  • jan 2010::0,0,221
  • feb 2010::0,0,255
  • mar 2010::0,0,255
  • apr 2010::63,0,255
  • may 2010::53,0,221
  • jun 2010::0,0,221
  • jul 2010::0,0,221
  • aug 2010::0,44,221
  • sep 2010::0,0,255
  • oct 2010::0,0,221
  • nov 2010::63,0,255
  • dec2010::0,0,255
  • 1

• Plant Room. Is the condenser coil in good condition?

  Yes

  No

  N/A

• Plant Room. Is the condensate tray clean and free of blockages?

  Yes

  No

  N/A

• Plant Room. Are there any burning smells?

  Yes

  No

  N/A

• Type in further information here......

Cooling Tower

• Cooling Tower. Are cooling towers leaking?

  Yes

  No

  N/A

• Type in further information here......

• Cooling Tower. Is it within the PM test date? And when was last date tested?

  Yes

  No

  N/A

• Date last tested

  Select jan 2013::0,0,255 feb 2013::63,0,255 mar 2013::63,0,255 apr 2013::63,0,255 may 2013::63,0,255 jun 2013::63,0,255 jul 2013::63,0,255 aug 2013::63,0,255 sep 2013::63,0,255 oct 2013::63,0,255 nov 2013::63,0,255 dec 2013::63,0,255 jan 2012::63,0,255 feb 2012::63,0,255 mar 2012::0,0,255 apr 2012::53,0,221 may 2012::0,0,255 jun 2012::63,0,255 jul 2012::0,0,221 aug 2012::63,0,255 sept 2012::63,0,255 oct 2012::53,0,221 nov 2012::53,0,221 dec 2012::63,0,255 jan 2011::0,0,221 feb 2011::63,0,255 mar 2011::53,0,221 apr 2011::53,0,221 may 2011::0,0,221 apr 2011::0,0,255 may 2011::53,0,221 jun 2011::53,0,221 jul 2011::53,0,221 aug 2011::0,0,255 sep 2011::0,0,255 oct 2011::0,0,221 nov 2011::0,0,255 dec 2011::63,0,255 jan 2010::0,0,221 feb 2010::0,0,255 mar 2010::0,0,255 apr 2010::63,0,255 may 2010::53,0,221 jun 2010::0,0,221 jul 2010::0,0,221 aug 2010::0,44,221 sep 2010::0,0,255 oct 2010::0,0,221 nov 2010::63,0,255 dec2010::0,0,255 1

  • jan 2013::0,0,255
  • feb 2013::63,0,255
  • mar 2013::63,0,255
  • apr 2013::63,0,255
  • may 2013::63,0,255
  • jun 2013::63,0,255
  • jul 2013::63,0,255
  • aug 2013::63,0,255
  • sep 2013::63,0,255
  • oct 2013::63,0,255
  • nov 2013::63,0,255
  • dec 2013::63,0,255
  • jan 2012::63,0,255
  • feb 2012::63,0,255
  • mar 2012::0,0,255
  • apr 2012::53,0,221
  • may 2012::0,0,255
  • jun 2012::63,0,255
  • jul 2012::0,0,221
  • aug 2012::63,0,255
  • sept 2012::63,0,255
  • oct 2012::53,0,221
  • nov 2012::53,0,221
  • dec 2012::63,0,255
  • jan 2011::0,0,221
  • feb 2011::63,0,255
  • mar 2011::53,0,221
  • apr 2011::53,0,221
  • may 2011::0,0,221
  • apr 2011::0,0,255
  • may 2011::53,0,221
  • jun 2011::53,0,221
  • jul 2011::53,0,221
  • aug 2011::0,0,255
  • sep 2011::0,0,255
  • oct 2011::0,0,221
  • nov 2011::0,0,255
  • dec 2011::63,0,255
  • jan 2010::0,0,221
  • feb 2010::0,0,255
  • mar 2010::0,0,255
  • apr 2010::63,0,255
  • may 2010::53,0,221
  • jun 2010::0,0,221
  • jul 2010::0,0,221
  • aug 2010::0,44,221
  • sep 2010::0,0,255
  • oct 2010::0,0,221
  • nov 2010::63,0,255
  • dec2010::0,0,255
  • 1

• General condition of cooling tower

  Select option:1:230,230,230

  Good:1:230,230,230

  Average:0:230,230,230

  Poor:1:230,230,230

  1

• Service delicatessen . Is the Chicken Cooker clean?

  Yes

  No

  N/A

• Add media

  Media

Materials Handling

• Does the Site have (electric / LPG / petrol) materials handling equipment?

  Yes

  No

  N/A

• Are battery chargers for FWR / PJE in good condition?

  Yes

  No

  N/A

• Are Battery Chargers securely fixed to the wall?

  Yes

  No

  N/A

• Are leads and connections in good condition?

  Yes

  No

  N/A

• Is the forklift in good condition?

  Yes

  No

  N/A

• Is the forklift registered?

  Yes

  No

  N/A

• The Forklift is registered until....

  Select jan 2013::0,0,255 feb 2013::63,0,255 mar 2013::63,0,255 apr 2013::63,0,255 may 2013::63,0,255 jun 2013::63,0,255 jul 2013::63,0,255 aug 2013::63,0,255 sep 2013::63,0,255 oct 2013::63,0,255 nov 2013::63,0,255 dec 2013::63,0,255 jan 2012::63,0,255 feb 2012::63,0,255 mar 2012::0,0,255 apr 2012::53,0,221 may 2012::0,0,255 jun 2012::63,0,255 jul 2012::0,0,221 aug 2012::63,0,255 sept 2012::63,0,255 oct 2012::53,0,221 nov 2012::53,0,221 dec 2012::63,0,255 jan 2011::0,0,221 feb 2011::63,0,255 mar 2011::53,0,221 apr 2011::53,0,221 may 2011::0,0,221 apr 2011::0,0,255 may 2011::53,0,221 jun 2011::53,0,221 jul 2011::53,0,221 aug 2011::0,0,255 sep 2011::0,0,255 oct 2011::0,0,221 nov 2011::0,0,255 dec 2011::63,0,255 jan 2010::0,0,221 feb 2010::0,0,255 mar 2010::0,0,255 apr 2010::63,0,255 may 2010::53,0,221 jun 2010::0,0,221 jul 2010::0,0,221 aug 2010::0,44,221 sep 2010::0,0,255 oct 2010::0,0,221 nov 2010::63,0,255 dec2010::0,0,255 1

  • jan 2013::0,0,255
  • feb 2013::63,0,255
  • mar 2013::63,0,255
  • apr 2013::63,0,255
  • may 2013::63,0,255
  • jun 2013::63,0,255
  • jul 2013::63,0,255
  • aug 2013::63,0,255
  • sep 2013::63,0,255
  • oct 2013::63,0,255
  • nov 2013::63,0,255
  • dec 2013::63,0,255
  • jan 2012::63,0,255
  • feb 2012::63,0,255
  • mar 2012::0,0,255
  • apr 2012::53,0,221
  • may 2012::0,0,255
  • jun 2012::63,0,255
  • jul 2012::0,0,221
  • aug 2012::63,0,255
  • sept 2012::63,0,255
  • oct 2012::53,0,221
  • nov 2012::53,0,221
  • dec 2012::63,0,255
  • jan 2011::0,0,221
  • feb 2011::63,0,255
  • mar 2011::53,0,221
  • apr 2011::53,0,221
  • may 2011::0,0,221
  • apr 2011::0,0,255
  • may 2011::53,0,221
  • jun 2011::53,0,221
  • jul 2011::53,0,221
  • aug 2011::0,0,255
  • sep 2011::0,0,255
  • oct 2011::0,0,221
  • nov 2011::0,0,255
  • dec 2011::63,0,255
  • jan 2010::0,0,221
  • feb 2010::0,0,255
  • mar 2010::0,0,255
  • apr 2010::63,0,255
  • may 2010::53,0,221
  • jun 2010::0,0,221
  • jul 2010::0,0,221
  • aug 2010::0,44,221
  • sep 2010::0,0,255
  • oct 2010::0,0,221
  • nov 2010::63,0,255
  • dec2010::0,0,255
  • 1

• Does the forklift have a Gas Compliance plate?

  Yes

  No

  N/A

• Add media

  Media

Pallet Racking

• Site has pallet racking

  select your response:1:230,230,230

  yes :0:230,230,230

  no:1:230,230,230

  n/a:1:230,230,230

  1

• Are the Safe Work Load signs in place?

  Yes

  No

  N/A

• Is the Pallet racking in good condition at time of inspection?

  Yes

  No

  N/A

• Add media

  Media

Lifts / Travelators / Escalators

• Does the site have Lifts ?

  select your response:1:230,230,230

  yes :0:230,230,230

  no:1:230,230,230

  n/a:1:230,230,230

  1

• Does the site have Escalators ?

  select your response:1:230,230,230

  yes :0:230,230,230

  no:1:230,230,230

  n/a:1:230,230,230

  1

• Does the site have Traveltors ?

  select your response:1:230,230,230

  yes :0:230,230,230

  no:1:230,230,230

  n/a:1:230,230,230

  1

• Are lifts clean, well lit and are the emergency phones operational?

  Yes

  No

  N/A

• Are the Lifts / Escalators / Travelators in good condition and no repairs required?

  Yes

  No

  N/A

• Are Compliance Maintenance records on site?

  Yes

  No

  N/A

• Are the Lifts / Travelators registered ?

  Yes

  No

  N/A

• Travelator registered until

  Select jan 2013::0,0,255 feb 2013::63,0,255 mar 2013::63,0,255 apr 2013::63,0,255 may 2013::63,0,255 jun 2013::63,0,255 jul 2013::63,0,255 aug 2013::63,0,255 sep 2013::63,0,255 oct 2013::63,0,255 nov 2013::63,0,255 dec 2013::63,0,255 jan 2012::63,0,255 feb 2012::63,0,255 mar 2012::0,0,255 apr 2012::53,0,221 may 2012::0,0,255 jun 2012::63,0,255 jul 2012::0,0,221 aug 2012::63,0,255 sept 2012::63,0,255 oct 2012::53,0,221 nov 2012::53,0,221 dec 2012::63,0,255 jan 2011::0,0,221 feb 2011::63,0,255 mar 2011::53,0,221 apr 2011::53,0,221 may 2011::0,0,221 apr 2011::0,0,255 may 2011::53,0,221 jun 2011::53,0,221 jul 2011::53,0,221 aug 2011::0,0,255 sep 2011::0,0,255 oct 2011::0,0,221 nov 2011::0,0,255 dec 2011::63,0,255 jan 2010::0,0,221 feb 2010::0,0,255 mar 2010::0,0,255 apr 2010::63,0,255 may 2010::53,0,221 jun 2010::0,0,221 jul 2010::0,0,221 aug 2010::0,44,221 sep 2010::0,0,255 oct 2010::0,0,221 nov 2010::63,0,255 dec2010::0,0,255 1

  • jan 2013::0,0,255
  • feb 2013::63,0,255
  • mar 2013::63,0,255
  • apr 2013::63,0,255
  • may 2013::63,0,255
  • jun 2013::63,0,255
  • jul 2013::63,0,255
  • aug 2013::63,0,255
  • sep 2013::63,0,255
  • oct 2013::63,0,255
  • nov 2013::63,0,255
  • dec 2013::63,0,255
  • jan 2012::63,0,255
  • feb 2012::63,0,255
  • mar 2012::0,0,255
  • apr 2012::53,0,221
  • may 2012::0,0,255
  • jun 2012::63,0,255
  • jul 2012::0,0,221
  • aug 2012::63,0,255
  • sept 2012::63,0,255
  • oct 2012::53,0,221
  • nov 2012::53,0,221
  • dec 2012::63,0,255
  • jan 2011::0,0,221
  • feb 2011::63,0,255
  • mar 2011::53,0,221
  • apr 2011::53,0,221
  • may 2011::0,0,221
  • apr 2011::0,0,255
  • may 2011::53,0,221
  • jun 2011::53,0,221
  • jul 2011::53,0,221
  • aug 2011::0,0,255
  • sep 2011::0,0,255
  • oct 2011::0,0,221
  • nov 2011::0,0,255
  • dec 2011::63,0,255
  • jan 2010::0,0,221
  • feb 2010::0,0,255
  • mar 2010::0,0,255
  • apr 2010::63,0,255
  • may 2010::53,0,221
  • jun 2010::0,0,221
  • jul 2010::0,0,221
  • aug 2010::0,44,221
  • sep 2010::0,0,255
  • oct 2010::0,0,221
  • nov 2010::63,0,255
  • dec2010::0,0,255
  • 1

• Add media

  Media

Cleaners Room

• Does the site have a cleaners room?

  select your response:1:230,230,230

  yes :0:230,230,230

  no:1:230,230,230

  n/a:1:230,230,230

  1

• Is the Electrical Test and Tag of cleaners equipment in date?

  Yes

  No

  N/A

• Date last tested

  1

• Are the gas bottles stored on site in date?

  Yes

  No

  N/A

• Date last tested

  1

• Is the site compliant with a maximum of 2 gas bottles?

  Yes

  No

  N/A

• Add media

  Media

Automatic Doors

• Does the site have auto doors?

  select your response:1:230,230,230

  yes :0:230,230,230

  no:1:230,230,230

  n/a:1:230,230,230

  1

• Is it within the test date?

  Yes

  No

  N/A

• Date last tested

  select your response:1:230,230,230

  yes :0:230,230,230

  no:1:230,230,230

  n/a:1:230,230,230

  1

• Are the doors in working order?

  Yes

  No

  N/A

• Add media

  Media

Floors in preparation areas

Bakery

• What is the floor type?

  MMA::0,0,221

  Epoxy::63,0,255

  Vinyl:1:230,230,230

  Ceramic:1:230,230,230

  1

• What is the floor condition?

  Select option:1:230,230,230

  Good:1:230,230,230

  Average:0:230,230,230

  Poor:1:230,230,230

  1

• What is the proover floor condition?

  Select option:1:230,230,230

  Good:1:230,230,230

  Average:0:230,230,230

  Poor:1:230,230,230

  1

• Are strainers and baskets installed?

  Yes

  No

  N/A

• Add media

  Media

Deli

• What is the floor type?

  MMA::0,0,221

  Epoxy::63,0,255

  Vinyl:1:230,230,230

  Ceramic:1:230,230,230

  1

• What is the floor condition?

  Select option:1:230,230,230

  Good:1:230,230,230

  Average:0:230,230,230

  Poor:1:230,230,230

  1

• What is the floor condition of the Chicken Cooker area?

  Yes

  No

  N/A

• Are strainers and baskets installed?

  Yes

  No

  N/A

• Add media

  Media

Seafood

• What is the floor type?

  MMA::0,0,221

  Epoxy::63,0,255

  Vinyl:1:230,230,230

  Ceramic:1:230,230,230

  1

• What is the floor condition?

  Select option:1:230,230,230

  Good:1:230,230,230

  Average:0:230,230,230

  Poor:1:230,230,230

  1

• Are strainers and baskets installed?

  Yes

  No

  N/A

• Add media

  Media

Produce

• What is the floor type?

  MMA::0,0,221

  Epoxy::63,0,255

  Vinyl:1:230,230,230

  Ceramic:1:230,230,230

  1

• What is the floor condition?

  Select option:1:230,230,230

  Good:1:230,230,230

  Average:0:230,230,230

  Poor:1:230,230,230

  1

• Are strainers and baskets installed?

  Yes

  No

  N/A

• Add media

  Media

Meat

• What is the floor type?

  MMA::0,0,221

  Epoxy::63,0,255

  Vinyl:1:230,230,230

  Ceramic:1:230,230,230

  1

• What is the floor condition?

  Select option:1:230,230,230

  Good:1:230,230,230

  Average:0:230,230,230

  Poor:1:230,230,230

  1

• Are strainers and baskets installed?

  Yes

  No

  N/A

• Add media

  Media

Petrol Site Equipment

• LPG tank (above ground only) - date of last 10 year inspection?

  Select 2002:1:230,230,230 2003:1:230,230,230 2004:1:230,230,230 2005:1:230,230,230 2006:1:230,230,230 2007:1:230,230,230 2008:0:230,230,230 2009:1:230,230,230 2010:1:230,230,230 2011:1:230,230,230 2012:1:230,230,230 :1:230,230,230 1

  • 2002:1:230,230,230
  • 2003:1:230,230,230
  • 2004:1:230,230,230
  • 2005:1:230,230,230
  • 2006:1:230,230,230
  • 2007:1:230,230,230
  • 2008:0:230,230,230
  • 2009:1:230,230,230
  • 2010:1:230,230,230
  • 2011:1:230,230,230
  • 2012:1:230,230,230
  • :1:230,230,230
  • 1

• Add media

  Media

General Site issues that require remediation not already covered

• Please make a note of any hazards not already identified in this report.

• Add media

  Media

• Add media

  Media

• Add drawing

  Drawing

Workplace safety

• Please make a note of any issues not already identified in this report.

• Add media

  Media

• Add media

  Media

• Add drawing

  Drawing

Contractor Performance Survey. Survey the Store Manager on the nominated Service Provider for the Month.

• Service Provider Company Name is:

• Feb - Air Conditioning

  Yes

  No

  N/A

• March - Mechanical Hydraulic

  Yes

  No

  N/A

• April - Production Equipment

  Yes

  No

  N/A

• May - Fire

  Yes

  No

  N/A

• June - Electrical

  Yes

  No

  N/A

• July - Plumbing

  Yes

  No

  N/A

• Aug - CCTV / Alarm

  Yes

  No

  N/A

• September - EAS

  Yes

  No

  N/A

• October - Materials Handling

  Yes

  No

  N/A

• November - Refrigeration

  Yes

  No

  N/A

Service Provider Questions

• Does the technician attend within the required timeframe based on the priority?

  Select 1::255,255,255 2::255,255,255 3::255,255,255 4::255,255,255 5::255,255,255 6::255,255,255 7::255,255,255 8::255,255,255 9::255,255,255 10::255,255,255 ::255,255,255 1

  • 1::255,255,255
  • 2::255,255,255
  • 3::255,255,255
  • 4::255,255,255
  • 5::255,255,255
  • 6::255,255,255
  • 7::255,255,255
  • 8::255,255,255
  • 9::255,255,255
  • 10::255,255,255
  • ::255,255,255
  • 1

• Is the technician polite and courteous to Staff and Customers?

  Select 1::255,255,255 2::255,255,255 3::255,255,255 4::255,255,255 5::255,255,255 6::255,255,255 7::255,255,255 8::255,255,255 9::255,255,255 10::255,255,255 ::255,255,255 1

  • 1::255,255,255
  • 2::255,255,255
  • 3::255,255,255
  • 4::255,255,255
  • 5::255,255,255
  • 6::255,255,255
  • 7::255,255,255
  • 8::255,255,255
  • 9::255,255,255
  • 10::255,255,255
  • ::255,255,255
  • 1

• Is the technician neatly and appropriately presented?

  Select 1::255,255,255 2::255,255,255 3::255,255,255 4::255,255,255 5::255,255,255 6::255,255,255 7::255,255,255 8::255,255,255 9::255,255,255 10::255,255,255 ::255,255,255 1

  • 1::255,255,255
  • 2::255,255,255
  • 3::255,255,255
  • 4::255,255,255
  • 5::255,255,255
  • 6::255,255,255
  • 7::255,255,255
  • 8::255,255,255
  • 9::255,255,255
  • 10::255,255,255
  • ::255,255,255
  • 1

• Does the technician comply fully with Woolworths Ltd store policies and procedures?

  Select 1::255,255,255 2::255,255,255 3::255,255,255 4::255,255,255 5::255,255,255 6::255,255,255 7::255,255,255 8::255,255,255 9::255,255,255 10::255,255,255 ::255,255,255 1

  • 1::255,255,255
  • 2::255,255,255
  • 3::255,255,255
  • 4::255,255,255
  • 5::255,255,255
  • 6::255,255,255
  • 7::255,255,255
  • 8::255,255,255
  • 9::255,255,255
  • 10::255,255,255
  • ::255,255,255
  • 1

• Does the technician have the Store Manager sign in the WAF and Permit to work on arrival and departure?

  Select 1::255,255,255 2::255,255,255 3::255,255,255 4::255,255,255 5::255,255,255 6::255,255,255 7::255,255,255 8::255,255,255 9::255,255,255 10::255,255,255 ::255,255,255 1

  • 1::255,255,255
  • 2::255,255,255
  • 3::255,255,255
  • 4::255,255,255
  • 5::255,255,255
  • 6::255,255,255
  • 7::255,255,255
  • 8::255,255,255
  • 9::255,255,255
  • 10::255,255,255
  • ::255,255,255
  • 1

• Does the technician use the Woolworths Ltd Permit to Work system as required?

  Select 1::255,255,255 2::255,255,255 3::255,255,255 4::255,255,255 5::255,255,255 6::255,255,255 7::255,255,255 8::255,255,255 9::255,255,255 10::255,255,255 ::255,255,255 1

  • 1::255,255,255
  • 2::255,255,255
  • 3::255,255,255
  • 4::255,255,255
  • 5::255,255,255
  • 6::255,255,255
  • 7::255,255,255
  • 8::255,255,255
  • 9::255,255,255
  • 10::255,255,255
  • ::255,255,255
  • 1

• Is the workmanship of the technician to a satisfactory / tradesmen like standard?

  Select 1::255,255,255 2::255,255,255 3::255,255,255 4::255,255,255 5::255,255,255 6::255,255,255 7::255,255,255 8::255,255,255 9::255,255,255 10::255,255,255 ::255,255,255 1

  • 1::255,255,255
  • 2::255,255,255
  • 3::255,255,255
  • 4::255,255,255
  • 5::255,255,255
  • 6::255,255,255
  • 7::255,255,255
  • 8::255,255,255
  • 9::255,255,255
  • 10::255,255,255
  • ::255,255,255
  • 1

• Does the technician carry appropriate parts / materials to complete the works in a timely manner?

  Select 1::255,255,255 2::255,255,255 3::255,255,255 4::255,255,255 5::255,255,255 6::255,255,255 7::255,255,255 8::255,255,255 9::255,255,255 10::255,255,255 ::255,255,255 1

  • 1::255,255,255
  • 2::255,255,255
  • 3::255,255,255
  • 4::255,255,255
  • 5::255,255,255
  • 6::255,255,255
  • 7::255,255,255
  • 8::255,255,255
  • 9::255,255,255
  • 10::255,255,255
  • ::255,255,255
  • 1

• Does the technician complete the works in an appropriate timeframe?

  Select 1::255,255,255 2::255,255,255 3::255,255,255 4::255,255,255 5::255,255,255 6::255,255,255 7::255,255,255 8::255,255,255 9::255,255,255 10::255,255,255 ::255,255,255 1

  • 1::255,255,255
  • 2::255,255,255
  • 3::255,255,255
  • 4::255,255,255
  • 5::255,255,255
  • 6::255,255,255
  • 7::255,255,255
  • 8::255,255,255
  • 9::255,255,255
  • 10::255,255,255
  • ::255,255,255
  • 1

• Does the technician leave the work area clean and tidy upon the completion of works?

  Select 1::255,255,255 2::255,255,255 3::255,255,255 4::255,255,255 5::255,255,255 6::255,255,255 7::255,255,255 8::255,255,255 9::255,255,255 10::255,255,255 ::255,255,255 1

  • 1::255,255,255
  • 2::255,255,255
  • 3::255,255,255
  • 4::255,255,255
  • 5::255,255,255
  • 6::255,255,255
  • 7::255,255,255
  • 8::255,255,255
  • 9::255,255,255
  • 10::255,255,255
  • ::255,255,255
  • 1

• Any further notes on Service Provider performance?

  Yes

  No

  N/A

• Add signature

  Sign