Premises Details

  • Job Sheet No.

  • Premises Name

  • Client/Site

  • Address
  • GPS Details

  • Premises Alias

  • Conducted on

Registered Owner's Details

Building Description

  • Number of significant buildings

  • Number of significant buildings >10

  • Is the building close to other sites/buildings

  • Is the premises in a rural location

  • Number of floors

  • Number >10

  • Is there a basement

  • Floors below

  • Height of building

  • Number >15

  • Access Code

  • Premises Floor Area
  • Floor

  • Area in m2

  • Access Code

Registered Owner Details

  • Registered Address of Owner
  • Owner's Telephone Number

Contact Person Details

  • Contact Name

  • Position

  • Email address

  • Phone Day

  • Mobile

  • Other

Occupancy Details

Total Occupancy Weekday

  • 09.00 - 18.00

  • 18.00 - 09.00

Total Occupancy Weekend

  • 09.00 - 18.00

  • 18.00 - 09.00

Sleeping Weekday

  • 09.00 - 18.00

  • 18.00 - 09.00

Sleeping Weekend

  • 09.00 - 18.00

  • 18.00 - 09.00

Staff Weekday

  • 09.00 - 18.00

  • 18.00 - 09.00

Staff Weekend

  • 09.00 - 18.00

  • 18.00 - 09.00

  • Number of occupancy non-ambulant

Building/Premises Details

  • Internal Communications

  • Intercepter Tanks

  • On-site Treatment Plant

  • Control/Comms Room

Sprinkler System

  • Is there a sprinkler system installed

  • Type/Location

  • Location of Stop Valve

  • Details of water supply

Drencher System

  • Is there a drencher system installed

  • Type/Location

  • Location details

  • Valve location details

  • Details of water supply

Inert Gas System

  • Is there an inert gas system installed

  • Type/Location

  • Controls location

  • Ventilation Details

Fire Fighting Facilities

  • Dry Riser

  • Foam Inlet

  • Static Storage

  • Water Retention System

  • Wet Riser

  • Fire fighting lifts

  • Fire fighting shafts

  • Fixed fire fighting equipment

Fire Extinguishers

Fire Extinguishers

    Fire Extinguishers
  • Location

  • Select date

  • Add media

Manual Call Points

Manual Call Points

  • Location

  • Add media

Fire Exit

Fire Exits

    Fire Exits
  • Location

  • Type of lock

  • Add media

Smoke Control

  • Natural Ventilation

  • Mechanical Ventilation

Automatic Fire Alarm System

  • System Installed

  • Type specify

  • Is the system maintained

  • By whom

  • Is the system monitored

  • By whom

  • Location of main control pane

  • Repeater panel
  • Location

  • Add media

Water Supplies/Hydrants

Hydrants

  • Location

  • Size of main (mm)

  • Water Proviider

  • Is there static storage

  • Static storage capacity

  • Is there a ring main

  • Ring maim pressure (bar)

Security systems

  • Smoke cloak system

  • Dogs

  • CCTV

  • Intruder Alarms

  • Security personnel

  • Secured and left

Potential Loss/Risk

  • Sole trader

  • Details

  • Exceptional value

  • Details

  • Heritage risk

  • Details/Salvage priorities

  • Community loss

  • Details

Services and Shut off locations

Electricity

  • Is there Electricity

  • Location

  • Type

Gas

  • Is there gas instaled

  • Type

  • Location of burner

  • Add media

  • Shut off location

  • Add media

  • Location of LPG Tank

  • Add media

  • Capacity of LPG Tank

  • Add media

Oil

  • Is there oil installed

  • Location of burner

  • Add media

  • Shut off location

  • Location of oil tank

  • Add media

  • Capacity of oil tank

  • Add media

Hazardous Processes

  • Large Cold Rooms

  • Plant or machinery through floors in the building

  • Internal refuse chute

  • Lasers

  • Waste disposal site

  • Machinery hazard

  • Electricity supply above 415V

  • Electromagnetic radiation

  • Grain storage

  • Dust extraction system

  • Explosive hazard

  • Other specify

Salvage Priorities

  • List any salvage priorities and locations

Site Access

  • Preferred site access

  • Location

  • Access/egress difficulties

  • Location

  • Add drawing

  • Add media

  • Notes

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.