Home
All industries
Motivair Site Survey
Motivair Site Survey
Gary Weston

Motivair Site Survey

Use this Template
Print as PDF
graphic of a hand making an okay sign ×

Free Motivair Site Survey Checklist

Use this Template

Information

  • Customer name and site name:

  • Customer Name

  • Customer Address

  • Motivair Job No.

A. General Site / Survey Information

Site Contact details

  • Site contact name:

  • Contact telephone No's:

  • Contact e-mail:

  • Survey carried out:

  • Survey completed by (Motivair Engineer):

General Site Information

  • How many Plant Rooms on Site

  • Number of surveys carried out on this site:

    • 1
    • 2
    • 3
    • 4
    • 5
    • more than 5

  • This survey relates to Plant Room Name/Building/Room 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. Compressors 1 and 2 - Information

Compressor 1 Information

  • Compressor Type

  • Location: Building No/Building Name

  • Manufacturer:

    • Compair
    • Atlas
    • I/Rand
    • HPC
    • Boge
    • Opus
    • FINI
    • Hiross
    • Hankinsom
    • Parker/DH
    • Denco
    • Other: State which

  • 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

  • Media

Compressor 2 Information

  • Compressor Type

  • Location: Building No/Building Name

  • Manufacturer:

    • Compair
    • Atlas
    • I/Rand
    • HPC
    • Boge
    • Opus
    • FINI
    • Hiross
    • Hankinsom
    • Parker/DH
    • Denco
    • Other: State which

  • 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

  • Media

C. Compressors 3 and 4 - Information

Compressor 3 Information

  • Compressor Type

  • Location: Building No/Building Name

  • Manufacturer:

    • Compair
    • Atlas
    • I/Rand
    • HPC
    • Boge
    • Opus
    • FINI
    • Hiross
    • Hankinsom
    • Parker/DH
    • Denco
    • Other: State which

  • 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

  • Media:

    • Air
    • Gas

Compressor 4 Information

  • Compressor Type

  • Location: Building No/Building Name

  • Manufacturer:

    • Compair
    • Atlas
    • I/Rand
    • HPC
    • Boge
    • Opus
    • FINI
    • Hiross
    • Hankinsom
    • Parker/DH
    • Denco
    • Other: State which

  • 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

  • Media:

    • Air
    • Gas

D. Compressors 5 and 6 - Information

Compressor 5 Information

  • Compressor Type

  • Location: Building No/Building Name

  • Manufacturer

    • Compair
    • Atlas
    • I/Rand
    • HPC
    • Boge
    • Opus
    • FINI
    • Hiross
    • Hankinsom
    • Parker/DH
    • Denco
    • Other: State which

  • 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

  • Media:

    • Air
    • Gas

Compressor 6 Information

  • Compressor Type

  • Location: Building No/Building Name

  • Manufacturer

    • Compair
    • Atlas
    • I/Rand
    • HPC
    • Boge
    • Opus
    • FINI
    • Hiross
    • Hankinsom
    • Parker/DH
    • Denco
    • Other: State which

  • 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

  • Media:

    • Air
    • Gas

E. Dryer 1 & 2 - Information

Dryer 1 Information

  • Location: Building No/Name

  • Dryer Type

  • Which compressor is this Dryer connected to

  • Dryer connection information:

  • Manufacturer

    • Compair
    • Atlas
    • I/Rand
    • HPC
    • Boge
    • Opus
    • FINI
    • Hiross
    • Hankinsom
    • Parker/DH
    • Denco
    • Other: State which

  • Other Manufacturer

  • Model No

  • Serial No

  • Kw Rating

  • Capacity (CFM etc)

  • Which Type of Refrigerant

  • Quantiy of Refrigerant

  • Port Size (inches)

  • Image of dryer 1

Dryer 2 Information

  • Location: Building No/Name

  • Dryer Type

  • Which compressor is this Dryer connected to

  • Dryer connection information:

  • Manufacturer

    • Compair
    • Atlas
    • I/Rand
    • HPC
    • Boge
    • Opus
    • FINI
    • Hiross
    • Hankinsom
    • Parker/DH
    • Denco
    • Other: State which

  • Other Manufacturer

  • Model No

  • Serial No

  • Kw Rating

  • Capacity (CFM etc)

  • Which Type of Refrigerant

  • Quantiy of Refrigerant

  • Port Size (inches)

  • Image of dryer 2

F. Dryer 3 & 4 - Information

Dryer 3 Information

  • Location: Building No/Name

  • Dryer Type

  • Which compressor is this Dryer connected to

  • Dryer connection information:

  • Manufacturer

    • Compair
    • Atlas
    • I/Rand
    • HPC
    • Boge
    • Opus
    • FINI
    • Hiross
    • Hankinsom
    • Parker/DH
    • Denco
    • Other: State which

  • Other Manufacturer

  • Model No

  • Serial No

  • Kw Rating

  • Capacity (CFM etc)

  • Which Type of Refrigerant

  • Quantity of Refrigerant

  • Port Size (inches)

  • Image of dryer 3

Dryer 4 Information

  • Location: Building No/Name

  • Dryer Type

  • Which compressor is this Dryer connected to

  • Dryer connection information:

  • Manufacturer

    • Compair
    • Atlas
    • I/Rand
    • HPC
    • Boge
    • Opus
    • FINI
    • Hiross
    • Hankinsom
    • Parker/DH
    • Denco
    • Other: State which

  • Other Manufacturer

  • Model No

  • Serial No

  • Kw Rating

  • Capacity (CFM etc)

  • Which Type of Refrigerant

  • Quantity of Refrigerant

  • Port Size (inches)

  • Image of dryer 4

G. Receivers

Receivers

  • How many receivers are fitted

Receiver 1

  • Location:

  • Manufacturer:

  • Other Manufacturer:

  • Serial No:

  • Volume (Ltrs):

  • Date of Manufacture:

  • Max Safe Working Pressure:

  • Receiver orientation

    • Vertical
    • Horizontal

  • Wet or Dry receiver:

    • Wet
    • Dry

  • Receiver drain type:

    • Electronic Zero loss drain
    • Timed drain
    • Drip leg drain
    • Ball valve

  • Receiver drain detail:

  • Images of Air Receiver 1

Receiver 2

  • Location:

  • Manufacturer:

  • Other Manufacturer:

  • Serial No:

  • Volume (Ltrs):

  • Date of Manufacture:

  • Max Safe Working Pressure:

  • Receiver orientation

    • Vertical
    • Horizontal

  • Wet or Dry receiver:

    • Wet
    • Dry

  • Receiver drain type:

    • Electronic Zero loss drain
    • Timed drain
    • Drip leg drain
    • Ball valve

  • Receiver drain detail:

  • Images of Air Receiver 2

Receiver 3

  • Location:

  • Manufacturer:

  • Other Manufacturer:

  • Serial No:

  • Volume (Ltrs):

  • Date of Manufacture:

  • Max Safe Working Pressure:

  • Receiver orientation

    • Vertical
    • Horizontal

  • Wet or Dry receiver:

    • Wet
    • Dry

  • Receiver drain type:

    • Electronic Zero loss drain
    • Timed drain
    • Drip leg drain
    • Ball valve

  • Receiver drain detail:

  • Images of Air Receiver 3

Receiver 4

  • Location:

  • Manufacturer:

  • Other Manufacturer:

  • Volume (Ltrs):

  • Serial No:

  • Date of Manufacture:

  • Max Safe Working Pressure:

  • Receiver orientation

    • Vertical
    • Horizontal

  • Wet or Dry receiver:

    • Wet
    • Dry

  • Receiver drain type:

    • Electronic Zero loss drain
    • Timed drain
    • Drip leg drain
    • Ball valve

  • Receiver drain detail:

  • Images of Air Receiver 4

  • More than 4 receivers? Enter additional items here:

H. Filtration

Filtration

  • 1.0 MANUFACTURER

    • Compair
    • Atlas
    • I/Rand
    • HPC
    • Boge
    • Opus
    • FINI
    • Hiross
    • Hankinsom
    • Parker/DH
    • Denco
    • Other: State which

  • Location:

  • 1.1 Model No

  • 1.11 Element No

  • 1.12 Port Size (inches)

  • 1.13 Automatic Drain Fitted

  • 1.13.1 Autodrain Detail

  • Image of filter 1:

Filtration item 2

  • 2.0 MANUFACTURER

    • Compair
    • Atlas
    • I/Rand
    • HPC
    • Boge
    • Opus
    • FINI
    • Hiross
    • Hankinsom
    • Parker/DH
    • Denco
    • Other: State which

  • Location:

  • 2.1 Model No

  • 2.11 Element No

  • 2.12 Port Size (inches)

  • 2.13 Automatic Drain Fitted

  • 2.13.1 Autodrain Detail

  • Image of filter 2:

Filtration item 3

  • 3.0 MANUFACTURER

    • Compair
    • Atlas
    • I/Rand
    • HPC
    • Boge
    • Opus
    • FINI
    • Hiross
    • Hankinsom
    • Parker/DH
    • Denco
    • Other: State which

  • Location:

  • 3.1 Model No

  • 3.11 Element No

  • 3.12 Port Size (inches)

  • 3.13 Automatic Drain Fitted

  • 3.13.1 Autodrain Detail

  • Image of filter 3:

Filtration item 4

  • 4.0 MANUFACTURER

  • Location:

  • 4.1 Model No

  • 4.11 Element No

  • 4.12 Port Size (inches)

  • 4.13 Automatic Drain Fitted

  • 4.13.1 Autodrain Detail

  • Image of filter 4:

Filtration item 5

  • 5.0 MANUFACTURER

  • Location:

  • 5.1 Model No

  • 5.11 Element No

  • 5.12 Port Size (inches)

  • 5.13 Automatic Drain Fitted

  • 5.13.1 Autodrain Detail

  • Image of filter 5:

Filtration item 6

  • 6.0 MANUFACTURER

    • Compair
    • Atlas
    • I/Rand
    • HPC
    • Boge
    • Opus
    • FINI
    • Hiross
    • Hankinsom
    • Parker/DH
    • Denco
    • Other: State which

  • Location:

  • 6.1 Model No

  • 6.11 Element No

  • 6.12 Pot Size (inches)

  • 6.13 Automatic Drain Fitted

  • 6.13.1 Autodrain Detail

  • Images of filter 6:

Other Filtration information:

  • Other filtration information:

  • Other filtration images:

I. Condensate Management

Condensate Management

  • Is there a Condensate Management System Fitted

  • 1.0 Oil Water Separator 1

  • Location:

  • 1.1 Manufacturer

    • Compair
    • Atlas
    • I/Rand
    • HPC
    • Boge
    • Opus
    • FINI
    • Hiross
    • Hankinsom
    • Parker/DH
    • Denco
    • Other: State which

  • 1.2 Model No

  • 1.3 Serial No

  • Take Picture of OWS 1

  • 2.0 Oil Water Separator 2

  • Location:

  • 2.1 Manufacturer

    • Compair
    • Atlas
    • I/Rand
    • HPC
    • Boge
    • Opus
    • FINI
    • Hiross
    • Hankinsom
    • Parker/DH
    • Denco
    • Other: State which

  • 2.2 Model No

  • 2.3 Serial No

  • Take Picture of OWS 2

Any other condensate information:

  • Other condensate equipment info:

  • Other condensate images:

J. Additional Technical Information

Additional Technical Information

  • Add Free Text

  • Additional images:

K. Additional Site Information

Additional Site Information

  • Add Free Text

  • Motivair Stickers visible on all equipment

  • Is there any other equipment on site not surveyed on this visit? Pass lead to sales team. Please give details below:

    • Vacuum pumps
    • Blowers
    • Gas compressors
    • Spray Booth
    • Breathing Air Equipment
    • High Pressure Systems
    • Air tools
    • Written Scheme of Examination

L. Verification and Signature

  • Name

Motivair Site Survey
Gary Weston

Motivair Site Survey

Use this Template
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.

Related checklists

Motivair Site Survey - GWV2
Gary Weston
Motivair Site Survey - GWV2
85 Downloads
Motivair Site Survey - GWV2
Gary Weston
Motivair Site Survey - GWV2
85 Downloads
Motivair - Aggregate Industries V2
Brian Henry
Motivair - Aggregate Industries V2
89 Downloads
Motivair Compressed Air System Audit
Brian Henry
Motivair Compressed Air System Audit
190 Downloads
Motivair Compressed Air System Audit 2016.1
Anonymous
Motivair Compressed Air System Audit ...
51 Downloads
Motivair Compressed Air System Audit
Brian Henry
Motivair Compressed Air System Audit
33 Downloads
back arrow for carousel
back arrow for carousel
iAuditor Logo Icon ©SafetyCulture 2022