LOWE - Preliminary Site Assessment

• Client:

• Conducted on:

  Date

• Conducted by:

• Site Location:
  Address

• INSTRUCTIONS
  ---------------------
  1. Please answer the questions below.
  2. Add photos and notes by clicking on the paperclip icon
  3. To add a Corrective Action click on the paperclip icon then "Add Action," provide a description, assign to a member, set priority, and due date
  4. Complete audit by providing digital signature
  5. Share your report by exporting as PDF, Word, Excel or Web Link
  

Services

• Gas

  Yes

  No

  Not Sighted

• Power

  Yes

  No

  Not Sighted

• Water Meter

  Yes

  No

  Not Sighted

• Sewer

  Yes

  No

  Not Sighted

• Any overhead cables noted

  Yes

  No

  N/A

Existing Boundary Fencing:

• Left:

  Picket

  Palings

  Brick

  P&W Mesh Metal Brush

• Condition:

  Retain

  Replace/Repair

• Right:

  Picket

  Palings

  Brick

  P&W Mesh Metal Brush

• Condition:

  Retain

  Replace/Repair

• Rear:

  Picket

  Palings

  Brick

  P&W Mesh Metal Brush

• Condition:

  Retain

  Replace/Repair

• Private Open Space:

  Front Left

  Front Right

  Rear Left

  Rear Right

  Rear Width

Road Details and Condition

• Type

  Bitumen

  Concrete

  Brick

  Unmade

• Footpath

  Yes

  No

• Kerb and Channel

  Yes

  No

• Vehicle Crossing

  Yes

  No

• Rollover Kerb

  Yes

  No

Brief & Background

Note any Parking Restrictions & if permit area

• 

• Site

  Drawing

• Take a Photo

  Media

• Footpath

• Nature Strip

• Road

• Comments

• Council

  Yes

  No

  N/A

Sign-off

• Conducted by (Name & Signature) :

  Sign