Title Page
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Site name
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Conducted on
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Prepared by
Site Contact Details
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Manager Name
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Names of other managers/supervisors on site
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Site Address
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Site Phone Number
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Site Emergency Contact Number
Emergency Isolation Locations
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Do you know the location of the mains water isolation valve?
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Do you know the location of the mains gas isolation valve?
Site Planned Maintenance Checklist
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Tick all assets that are present within the unit
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Fire Alarm Panel
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Sprinklers
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Emergency Lighting
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Fire Extinguishers
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Ansul Fire Suppression System (Located within kitchens)
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LED Emergency 'Running Man' Signage
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Undersink Water Heaters
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Calorifier (Boiler / Immersion Boilers)
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Mixer Taps
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Thermostatic Mixer Valves
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Hot Taps
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Cold Taps
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Instantaneous Hot Water Taps
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Instantaneous Chilled Water Taps
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Push Bar Fire Doors
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Fire Door Closers
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Disabled Toilet Alarm
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Hand Dryers
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Handrails
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Overdoor Heaters
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Public Address System
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Air Conditioning
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Condenser Units (AC Outdoor Units)
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Air Handling Units (Filtration of Fresh Air)
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Booster Water Pumps (Mains Water)
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Cold Water Storage Tanks
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Shower Heads
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Spray Taps
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Fire Shutters
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Flues (Gas Boiler exhaust)
