Title Page

  • Conducted on

  • Prepared by

  • Location
    Start a window
  • Window Reference
    Each window must be given a unique reference in the format Floor level. Elevation. Window Number eg. GF.E.W1 The first two characters represent the floor level on which the window is located eg. GF, 1F, 2F, 3F, etc The middle character represents the elevation on which the window is located ie. N, S, E, W · The final two characters represent the unique window number assigned to the window eg. W1, W2, W3, etc

Survey

  • What Is window reference

  • Sketch to show window configuration

  • Within the box provided, draw a brief sketch to show the arrangement of the window, positions of fixed and opening lights, glass pane sizes, please add picture with dimensions and picture to be taken with openings showing

  • areas where security/solar film are present, etc. (Alternatively, if completing the form electronically a photograph could be inserted within the box)

  • Overall size of window opening

  • Record the overall size, width x height, of the window unit (structural opening size)

  • Cill height from Internal Floor Level

  • This is the height between the internal floor level and top of the window cill (Note: this distance should be measured accurately and not estimated)

  • Please record all measurements in millimetres (mm) for consistency

  • Record the material which the window frame is constructed from

  • Glazing Type

  • · Any glazing within a height of 800mm from internal floor level must be safety glazing

  • · In addition, any glazing within a 300mm distance either side of a door opening or similar must be safety glazing up to a height of 1500mm

  • Should there be any safety glass

  • Record whether any kite mark/BS/EN stamp etc present to the glazing to indicate the glazing is safety glazing (eg. BS EN 12600, BS 6206)

Glazing Condition

  • Record whether all glazing is present and if any damaged glazing is present

Solar Reflective/ Security film

  • Record whether all film is present and if any damaged film glazing is present.

  • Is the film damaged

Opening Type & restrictorsz

  • Record how the opening lights of the window open using the tick box options provided

  • NOTE: The maximum opening 'gap' should be 100mm

  • Record whether opening restrictors are fitted to each opening light of the window

  • Can the window lights be opened with ease,

  • record any issues which are causing/ contributing to this

Trickle Vents

  • Record whether any trickle vents present

  • any issues with their condition/ operation of the trickle vents

Window Locks

  • Record if window locks are present

  • Are the keys are available on site

Security

  • Consider whether there are any security or Health & Safety implications to the windows being open?

  • What are the issues

Summary / Remedial Works

  • PRIORITY RATING

Other remedial actions required:

  • Any other remedial actions required

Created by:

  • Date:

Works completed by:

  • Name:

Works accepted by:

  • Name:

Additional Windows

  • Do you want to add another window to survey

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.