Information

Site Equipment Audit

  • Job No:

  • Date of Survey

  • Customer Name

  • Customer Address
  • Site Contact Name

  • Contact Tel No:

  • Email Address

  • Engineer Name

A. General Site Information

General Site Information

  • How many Plant Rooms on Site

  • This Plan Room Name/Building No

  • 3. Does Motivair currently maintain the equipment - (if No - add detail)<br>

  • 4. Who currenly maintains the compressed air

  • 5. Does the Customer have other sites - if "Yes" add detail below<br><br>

  • 5.a. List Other Site Locations

  • 6. Is the customer interested in saving money on Energy and Service Costs

  • 7. Does the customer have a Written Scheme of Examination

B. Compressor 1 - Information

Compressor 1 Information

  • Compressor Type

  • Take a picture of the compressor

  • Location: Building No/Building Name

  • Manufacturer

  • Take a picture of the data plate

  • Model No

  • Serial No

  • Kw Rating

  • Pressure Rating

  • If High Pressure State Operating Pressure

  • Capcity (CFM etc)

  • Year of Manufacture

  • Running Hours

  • Next Service due

  • Are there any Faults with this compressor

  • What Oil is Used in this Compressor

  • Is there anything more Specific to this Compressor

  • List the Specific Detail here:

  • Take Picture of Compressor

C. Compressor 2 - Information

Compressor 2 Information

  • Compressor Type

  • Take a picture of the compressor

  • Location: Building No/Building Name

  • Manufacturer:

  • Take a picture of the data plate

  • Model No

  • Serial No

  • Kw Rating

  • Pressure Rating

  • Capacity (CFM)

  • Year of Manufacture

  • Running Hours

  • Next Service Due

  • Are there any Faults with this Compressor

  • What Oil is used in this Compressor

  • Is there anything more Specific to this Compressor

  • List the Specific Detail here:

  • Take Picture of Compressor

D. Compressor 3 - Information

Compressor 3 Information

  • Compressor Type

  • Take a picture of the compressor

  • Location: Building No/Building Name

  • Manufacturer

  • Take a picture of the data plate

  • Model

  • Serial No

  • Kw Rating

  • Pressure Rating

  • Capacity (CFM)

  • Year of Manufacturer

  • Running Hours

  • Next Service Due

  • Are there any FAULTS with this compressor

  • What Oil is used in this Compressor

  • Is there anything more specific to this Compressor

  • Add Specific Detail Here:

  • Take Picture of Compressor

E. Dryer 1 - Information

Dryer 1 Information

  • Dryer Type

  • Which compressor is this Dryer connected to

  • Manufacturer

  • Other Manufacturer

  • Model No

  • Serial No

  • Kw Rating

  • Capacity (CFM etc)

  • Which Type of Refrigerant

  • Quantiy of Refrigerant

  • Port Size (inches)

F. Dryer 2 - Information

Dryer 2 - Information

  • Dryer Type

  • Which Compressor is the Dryer connected to

  • Manufacturer

  • Other Manufacturer

  • Model No

  • Serial No

  • Kw Rating

  • Capacity (CFM etc)

  • Which type of Refrigerant

  • Quantity of Refrigerant

  • Port Size (inches)

G. Receivers

Receivers

  • How many receivers ar fitted

  • 1.0 Receiver

  • 1.1 Manufacturer

  • 1.11 Other Manufacturer

  • 1.2 Volume (Lt)

  • 1.3 Serial No

  • 1.4 Safe Working Pressure

  • 1.5 Wet or Dry Receiver

H. Filtration

Filtration

  • 1.0 MANUFACTURER

  • 1.1 Model No

  • 1.11 Element No

  • 1.12 Port Size (inches)

  • 1.13 Automatic Drain Fitted

  • 1.13.1 Autodrain Detail

  • 2.0 MANUFACTURER

  • 2.1 Model No

  • 2.11 Element No

  • 2.12 Port Size (inches)

  • 2.13 Automatic Drain Fitted

  • 2.13.1 Autodrain Detail

  • 3.0 MANUFACTURER

  • 3.1 Model No

  • 3.11 Element No

  • 3.12 Port Size (inches)

  • 3.13 Automatice Drain Fitted

  • 3.13.1 Autodrain Detail

  • 4.0 MANUFACTURER

  • 4.1 Model No

  • 4.11 Element No

  • 4.12 Port Size (inches)

  • 4.13 Automatic Drain Fitted

  • 4.13.1 Autodrain Detail

  • 5.0 MANUFACTURER

  • 5.1 Model No

  • 5.11 Element No

  • 5.12 Port Size (inches)

  • 5.13 Automatic Drain Fitted

  • 5.13.1 Autodrain Detail

  • 6.0 MANUFACTURER

  • 6.1 Model No

  • 6.11 Element No

  • 6.12 Pot Size (inches)

  • 6.13 Automatic Drain Fitted

  • 6.13.1 Autodrain Detail

I. Condensate Management

Condensate Management

  • Is there a Condensate Management System Fitted

  • 1.0 Oil Water Separator

  • 1.1 Manufacturer

  • 1.2 Model No

  • 1.3 Serial No

  • Take Picture of OWS

  • 2.0 Oil Water Separator

  • 2.1 Manufacturer

  • 2.2 Model No

  • 2.3 Serial No

  • Take Picture of OWS

J. Additional Technical Information

Additional Technical Information

  • Add Free Text

K. Additional Site Information

Additional Site Information

  • Add Free Text

L. Verification and Sgnature

  • Name

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.