M&E Condition Survey

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

General Building Information

• LV Switchgear
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LV Switchgear

• LV Switchgear condition

  A - as new operating as designed

  B - Minor Defects but operating as intended

  C - Major defects not operating as intended

  D - Life expired imminent risk of failure, statutory compliance

  n/a

• LV Switchgear Estimated PPM (years)

  0-1yrs

  2-5yrs

  6-10yrs

  11-15yrs

  16-25yrs

• LV Switchgear Comments

• Tick to include LV Switchgear Photos
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• LV Switchgear Photos

  Media

• Distribution Boards
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Distribution Boards

• Distribution Boards condition

  A - as new operating as designed

  B - Minor Defects but operating as intended

  C - Major defects not operating as intended

  D - Life expired imminent risk of failure, statutory compliance

  n/a

• Distribution Boards Estimated PPM (years)

  0-1yrs

  2-5yrs

  6-10yrs

  11-15yrs

  16-25yrs

• Distribution Boards Comments

• Tick to include Distribution Boards Photos
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• Distribution Boards Photos

  Media

• LV Distribution
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LV Distribution

• LV Distribution condition

  A - as new operating as designed

  B - Minor Defects but operating as intended

  C - Major defects not operating as intended

  D - Life expired imminent risk of failure, statutory compliance

  n/a

• LV Distribution Estimated PPM (years)

  0-1yrs

  2-5yrs

  6-10yrs

  11-15yrs

  16-25yrs

• LV Distribution Comments

• Tick to include LV Distribution Photos
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• LV Distribution Photos

  Media

• Fire Alarm System
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Fire Alarm System

• Fire Alarm System condition

  A - as new operating as designed

  B - Minor Defects but operating as intended

  C - Major defects not operating as intended

  D - Life expired imminent risk of failure, statutory compliance

  n/a

• Fire Alarm System Estimated PPM (years)

  0-1yrs

  2-5yrs

  6-10yrs

  11-15yrs

  16-25yrs

• Fire Alarm System Comments

• Tick to include Fire Alarm System Photos
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• Fire Alarm System Photos

  Media

Room Survey

Survey room

• Room name/number

Lighting

• Lighting Condition

  A - as new operating as designed

  B - Minor Defects but operating as intended

  C - Major defects not operating as intended

  D - Life expired imminent risk of failure, statutory compliance

  n/a

• Lighting Estimated PPM (years)

  0-1yrs

  2-5yrs

  6-10yrs

  11-15yrs

  16-25yrs

• Lighting Comments

• Tick to add Lighting Photos
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• Lighting Photos

  Media

Small Power

• Small Power Condition

  A - as new operating as designed

  B - Minor Defects but operating as intended

  C - Major defects not operating as intended

  D - Life expired imminent risk of failure, statutory compliance

  n/a

• Small Power Estimated PPM (years)

  0-1yrs

  2-5yrs

  6-10yrs

  11-15yrs

  16-25yrs

• Small Comments

• Tick to add Small Power Photos
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• Small Power Photos

  Media

Data

• Data Condition

  A - as new operating as designed

  B - Minor Defects but operating as intended

  C - Major defects not operating as intended

  D - Life expired imminent risk of failure, statutory compliance

  n/a

• Data Estimated PPM (years)

  0-1yrs

  2-5yrs

  6-10yrs

  11-15yrs

  16-25yrs

• Data Comments

• Tick to add Data Photos
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• Data Photos

  Media

Fire Alarms

• Fire Alarm Condition

  A - as new operating as designed

  B - Minor Defects but operating as intended

  C - Major defects not operating as intended

  D - Life expired imminent risk of failure, statutory compliance

  n/a

• Fire Alarm Estimated PPM (years)

  0-1yrs

  2-5yrs

  6-10yrs

  11-15yrs

  16-25yrs

• Fire Alarm Comments

• Tick to add Fire Alarm Photos
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• Fire Alarm Photos

  Media

Other

• Other Condition

  A - as new operating as designed

  B - Minor Defects but operating as intended

  C - Major defects not operating as intended

  D - Life expired imminent risk of failure, statutory compliance

  n/a

• Other Estimated PPM (years)

  0-1yrs

  2-5yrs

  6-10yrs

  11-15yrs

  16-25yrs

• Other Comments

• Tick to add Other Photos
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• Other Photos

  Media

Mechanical Room Survey

Survey Room

• Room name/number

Heating

• Heating Condition

  A - as new operating as designed

  B - Minor Defects but operating as intended

  C - Major defects not operating as intended

  D - Life expired imminent risk of failure, statutory compliance

  n/a

• Heating Estimated PPM (years)

  0-1yrs

  2-5yrs

  6-10yrs

  11-15yrs

  16-25yrs

• Heating Comments

• Heating Remedial Works Comments

• Heating Cost

• Heating Photos

  Media

Cooling

• Cooling Condition

  A - as new operating as designed

  B - Minor Defects but operating as intended

  C - Major defects not operating as intended

  D - Life expired imminent risk of failure, statutory compliance

  n/a

• Cooling Estimated PPM (years)

  0-1yrs

  2-5yrs

  6-10yrs

  11-15yrs

  16-25yrs

• Cooling Comments

• Cooling Remedial Works Comments

• Cooling Cost

• Cooling Photos

  Media

Water/Drainage

• Water / Drainage Condition

  A - as new operating as designed

  B - Minor Defects but operating as intended

  C - Major defects not operating as intended

  D - Life expired imminent risk of failure, statutory compliance

  n/a

• Water / Drainage Estimated PPM (years)

  0-1yrs

  2-5yrs

  6-10yrs

  11-15yrs

  16-25yrs

• Water/ Drainage Comments

• Water / Drainage Remedial Works Comments

• Water / Drainage Cost

• Water / Drainage Photos

  Media

Controls

• Controls Condition

  A - as new operating as designed

  B - Minor Defects but operating as intended

  C - Major defects not operating as intended

  D - Life expired imminent risk of failure, statutory compliance

  n/a

• Controls Estimated PPM (years)

  0-1yrs

  2-5yrs

  6-10yrs

  11-15yrs

  16-25yrs

• Controls Comments

• Controls Remedial Works Comments

• Controls Cost

• Controls Photos

  Media

Other

• Other Condition

  A - as new operating as designed

  B - Minor Defects but operating as intended

  C - Major defects not operating as intended

  D - Life expired imminent risk of failure, statutory compliance

  n/a

• Other Estimated PPM (years)

  0-1yrs

  2-5yrs

  6-10yrs

  11-15yrs

  16-25yrs

• Other Comments

• Other Remedial Works Comments

• Other Cost

• Other Photos

  Media

Electrical Plant Room Survey

Plant item

Electrical Plant Item

• Room name/number

• Plant Type

• Condition

  A - as new operating as designed

  B - Minor Defects but operating as intended

  C - Major defects not operating as intended

  D - Life expired imminent risk of failure, statutory compliance

  n/a

• Estimated PPM (years)

  0-1yrs

  2-5yrs

  6-10yrs

  11-15yrs

  16-25yrs

• Comments

• Remedial Works Comments

• Cost

• Photos

  Media

Mechanical Plant Room Survey

Mechanical Plant Item

• Room name/number

• Plant Type

• Condition

  A - as new operating as designed

  B - Minor Defects but operating as intended

  C - Major defects not operating as intended

  D - Life expired imminent risk of failure, statutory compliance

  n/a

• Estimated PPM (years)

  0-1yrs

  2-5yrs

  6-10yrs

  11-15yrs

  16-25yrs

• Comments

• Remedial Works Description

• Cost

• Photos

  Media