Information
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Assessment Number:
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Building Name:
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Assessment Conducted on
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Report Prepared by:
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Attendees
Building envelope/structure
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The physical elements on site
I.e: Walls, floors, ceiling, windows etc -
What is the general condition of the building form?
- N/A
- Very Poor
- Poor
- Fair
- Good
- Excellent
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Building Fitout
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Anything that is fixed to the building envelope
I.e: Fittings, fixtures, cabinetry etc. -
What is the general condition of the ceilings and internal walls?
- N/A
- Very Poor
- Poor
- Fair
- Good
- Excellent
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Notes:
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What is the general condition of the kitchen facilities?
- N/A
- Very Poor
- Poor
- Fair
- Good
- Excellent
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What is the general condition of the toilet facility?
- N/A
- Very Poor
- Poor
- Fair
- Good
- Excellent
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Notes:
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Electrical Services
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Anything that is powered by electricity and/or the control and distribution of electricity.
I.e: Lights, power points, appliances and the control
I.e: Distribution of electricity (switchboards, panels, solar etc. -
What is the general condition of the lighting system(s)?
- N/A
- Very Poor
- Poor
- Fair
- Good
- Excellent
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Notes:
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What is the general condition of the electrical boards (ie switchboards, sub boards, main boards etc)?
- N/A
- Very Poor
- Poor
- Fair
- Good
- Excellent
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Notes:
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Photo's:
Fire Services
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Anything that is required to control fire.
I.e:
Fire Monitoring - Connection of building to alarm system (i.e. security control centre)
Fire Panels/detection - Alarm, sensor's, FIP's.
Fire Warning Systems - EWIS
Fire Equipment - Hose reels, extinguishers etc
Fire Appliance Support - Accessibility for fire brigade, external service (hydrants and pumps)
ESM for Fire Evacuation - Emergency doors, emergency lighting, emergency exits, signage and evac plan signage. -
What is the general condition of the fire service elements (ie smoke detectors, fire panels, sprinklers etc)?
- N/A
- Very Poor
- Poor
- Fair
- Good
- Excellent
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Notes:
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Hydraulic Services
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Anything that moves fluids from one area to another.
I.e: Plumbing, sewerage, potable water supply (drinking water), septic tanks, grease traps, roof plumbing, drains, general pits (SW), TMV's, Backflow prevention devices. -
What is the general condition of the hydraulic service elements?
- N/A
- Very Poor
- Poor
- Fair
- Good
- Excellent
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Notes:
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Mechanical Services
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Anything that uses water, gas, electricity, and any other form of energy to move a machine.
I.e: HVAC, general machinery, lifts, elevators, pumping plant, roller doors and shutters. -
What is the general condition of the heating, ventilation and air conditioning (HVAC) systems?
- N/A
- Very Poor
- Poor
- Fair
- Good
- Excellent
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Notes:
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Flooring
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Floor sub structure and coverings.
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What is the general condition of the floor structure? (i.e. Subfloor)
- N/A
- Very Poor
- Poor
- Fair
- Good
- Excellent
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What is the general condition of the floor coverings?
- N/A
- Very Poor
- Poor
- Fair
- Good
- Excellent
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Notes:
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Roof
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Roof structure and configuration.
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What is the general condition of the roof structure?
- N/A
- Very Poor
- Poor
- Fair
- Good
- Excellent
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Notes:
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