HVAC Inspection - duplicate

• Conducted on

  Date

• Prepared by

• Location
  Address

Disclaimer

• The assessors believe the information contained within this risk assessment report to be correct at the time of printing. The assessors do not accept responsibility for any consequences arising from the use of the information herein. The report is based on matters which were observed or came to the attention of the assessors during the day of the assessment and should not be relied upon as an exhaustive record of all possible risks or hazards that may exist or potential improvements that can be made. Information on the latest workers compensation and OHS / WHS laws can be found at the relevant State WorkCover / WorkSafe Authority

Confidentiality Statement

• In order to maintain the integrity and credibility of the risk assessment processes and to protect the parties involved, it is understood that the assessors will not divulge to unauthorized persons any information obtained during this risk assessment unless legally obligated to do so

Table of Contents

• Equipment Inspection Checklist - 0/28 - 0%

  Yes

  No

  N/A

• Question

  Yes

  No

  N/A

Response

Details

• Type of Call

Site Risk Assessment

• Noise of acceptable level

  Yes

  No

  N/A

• Adequate Lighting

  Yes

  No

  N/A

• Walkways/Work areas clear

  Yes

  No

  N/A

• Access to Equipment adequate

  Yes

  No

  N/A

• Manual handling load adequate

  Yes

  No

  N/A

• Ladder height under 2 meters

  Yes

  No

  N/A

• 2 Meters from edge of roof

  Yes

  No

  N/A

• Machine guarding adequate

  Yes

  No

  N/A

• Is plant electrically isolated & safe

  Yes

  No

  N/A

• Is task clear of haz. Subs/Chemicals

  Yes

  No

  N/A

• Is task of clear of hot works

  Yes

  No

  N/A

• Area clear of confined space

  Yes

  No

  N/A

• No further noticeable hazards

  Yes

  No

  N/A

Rooftop Units (RTU)/Make-Up Air Units (MUA)/Air Handling Units (AHU)

• Rooftop/Make-Up Air/Air Handling equipment inspected on this maintenance visit?

  Yes

  No

  N/A

• RAC

  Yes

  No

  N/A

• Are RAC present

  Yes

  No

  N/A

Split Systems (SS)

• Split System Equipment Inspected on this Visit?

  Yes

  No

  N/A

Split Ducted Systems

Split Ducted Systems Inspected on this Visit

• Evaporative coolers

  Yes

  No

  N/A

• Evap coolers Inspected on this Visit?

  Yes

  No

  N/A

Air Cooled Condenser Units (ACC)

• Air Cooled Condenser Units Inspected on this Visit?

• Heat Pumps (HP)

  Yes

  No

  N/A

• Water Source Heat Pumps Inspected on this visit?

  Yes

  No

  N/A

Chillers

• Chillers Inspected on this Visit?

  Yes

  No

  N/A

Cooling Towers/Evaporative Condensers

• Cooling Towers Inspected on this Visit?

  Yes

  No

  N/A

Exhaust Fans (EF)

• Exhaust Fan equipment inspected on this visit?

  Yes

  No

  N/A

• Radiant Heaters (RH)/Unit Heaters (UH)

  Yes

  No

  N/A

• Radiant Heaters/Unit Heaters inspected on this maintenance visit?

  Yes

  No

  N/A

Mechanical & Electrical Switch Boards

• Mechanical & Electrical Switch Boards inspected on this visit

  Yes

  No

  N/A

• Boilers (B)

  Yes

  No

  N/A

• Were any boilers inspected on this inspection visit?

  Yes

  No

  N/A

Hot Water Tanks (HWT)

• Are there any hot water tanks inspected on this maintenance inspection?

  Yes

  No

  N/A

• Findings, Recommendations & Sign-Off - 0/2 - 0%

Preventative Maintenance Findings

• Are there any equipment issues discovered during this audit?

  Yes

  No

  N/A

• Are there any general audit notes or comments?

  Yes

  No

  N/A

Equipment Replacements/Additions

• Has any of the equipment covered under this maintenance agreement been replaced since the last inspection?

  Yes

  No

  N/A

• Has any additional HVAC equipment been installed at this facility since the last maintenance inspection?

  Yes

  No

  N/A

Maintenance Audit Sign-Off

• This maintenance inspection was completed as per

  Yes

  No

  N/A