IRISS site assessment

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Select date

  Date

Site Industry Information

• picture of asset

  Media

Nameplate Data

• Manufacturer

• Voltage

• Nameplate data

  Media

Window Assessment

• Has a Hrc category been assigned?

  Select No survey completed HRC 0 HRC 1 HRC 2 HRC 3 HRC 4 No PPE exists

  • No survey completed
  • HRC 0
  • HRC 1
  • HRC 2
  • HRC 3
  • HRC 4
  • No PPE exists

• Is there a need for windows?

  Yes

  No

  N/A

• Product needed?

  Select VPFR-50 VPFR-75 VPFR-100 CAP-6 CAP-C-6 CAP-VC-6 CAP-VCH-6 CAP-T-6 CAP-TC-6 CAP-12 CAP-C-12 CAP-VC-12 CAP-VCH-12 CAP-T-12 CAP-TC-12 CAP-24 CAP-C-24 CAP-VC-24 CAP-VCH-24 CAP-T-24 CAP-TC-24 VP-12-US none

  • VPFR-50
  • VPFR-75
  • VPFR-100
  • CAP-6
  • CAP-C-6
  • CAP-VC-6
  • CAP-VCH-6
  • CAP-T-6
  • CAP-TC-6
  • CAP-12
  • CAP-C-12
  • CAP-VC-12
  • CAP-VCH-12
  • CAP-T-12
  • CAP-TC-12
  • CAP-24
  • CAP-C-24
  • CAP-VC-24
  • CAP-VCH-24
  • CAP-T-24
  • CAP-TC-24
  • VP-12-US
  • none

• Is there a certain location the window needs to be placed

  Drawing

• Quantity