Title Page
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Conducted on
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Prepared by
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Fire alarm testing via call point completed?
- No Issues
- Call point not working
- Break glass broken
- Call point obstructed
- No call point key
- Call point damaged
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Emergency light test
- No issues
- Test key not available
- No fish key
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Emergency light visual check
- No issues
- Neon light not working
- Neon light not visible
- Light unit cracked
- Light permanently on
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Fire exits clear and door opens correctly
- No issues
- Push bar/pad broken
- Push bar/pad missing
- Exit blocked/obstructed
- Opens in wrong direction
- Redlam bolt missing
- Door damaged
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Fire fighting equipment
- No issues
- Damaged
- Leaking
- Out of service date (12 months)
- Operating instructions missing
- Not mounted on plinth or wall
- Obstructed
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Sprinkler Valve check
- No issues
- Obstructed
- Damaged
- Leaking
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Portable appliance check
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First aid box checked
- No issues
- Out of expiry date
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Air conditioning check
- No issues
- Not working
- Inaccessible
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Stop cock register
- No issue
- Damaged
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Asbestos containing material visual check
- No Asbestos
- No issues
- Asbestos report available
- Locations marked
- Locations not marked
- Locations damaged
- Locations undamaged
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Access equipment inspection
- No issues
- No access equipment in store
- Visible damage
- Domestic ladder
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Pallet truck inspection
- No issues
- No pallet truck in Store
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Heating
- No issues
- Partial heating
- Over door heating only
- No heating
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Hot water
- No issues
- Kitchen only
- Toilet only
- No hot water in building
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Lift/scissor lift
- No issues
- No lift
- Out of use
- Unknown
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Front of Store shutters
- Automatic
- Manual
- N/A
- No isuues
- Not working
- Out of use
- Unknown
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Delivery bay shutters
- Automatic
- Manual
- N/A
- No isuues
- Not working
- Out of use
- Unknown
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Entrance door/automatic door/glazing
- Automatic
- Manual
- N/A
- No isuues
- Not working
- Out of use
- Unknown
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Store lighting status - sales floor
- Good
- Average
- Poor
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Store light status - other areas
- Good
- Average
- Poor
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Cold water tank
- No issues
- N/A
- Damaged
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Store Name and address
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Comments
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Sign when completed
