Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Facility Address

  • Photo of Store Front

  • Address:
  • Are there any special parking arrangements?

  • If yes please describe.

IT Cabinet Room

  • Photo of the front of the cabinet.

  • Photo of the rear of the cabinet.

  • Photo of the patch panel zoomed in.

  • Cable Type and amount required

Main Power Room or Distribution Board

  • Photo of Main power room

  • Photo of DB and Type.

  • Photo of Existing Power Socket Type

  • Note Existing Power Socket & Cable Type

Facility Information

  • Are there any health and safety requirements to work on site at the store?

  • If yes please describe.

  • Are there any obvious signs of Asbestos Materials

  • If yes please describe.

  • Are there any special store instructions for the installation or night of the cutover?

  • If yes please describe.

  • Install to be done out of hours!

  • Is there a ladder long enough to reach the ceiling if necessary?

Security Arrangements

Security Requirements into the building.

  • Is an electronic badge required?

  • If yes, list the contact information to receive badge!

  • Is a door key required?

  • If yes, list the contact information to receive key!

  • Is a security guard sign in required?

  • If yes, list the contact information for getting on the access roster!

  • Is an escort required?

  • If yes, list the contact information for the escort!

  • Are different access access requirements needed during business hours and after store closure?

  • If yes, please detail the various requirements!

Security Requirements into the Staging/IT Room

  • Is an electronic badge required?

  • If yes, list the contact information to receive badge!

  • Is a door key required?

  • If yes, list the contact information to receive key!

  • Is a security guard sign in required?

  • If yes, list the contact information for getting on the access roster!

  • Is an escort required?

  • If yes, list the contact information for the escort!

  • Are different access access requirements needed during business hours and after store closure?

  • If yes, please detail the various requirements!

  • Are there any other security requirements to access the staging room?

Equipment Location

  • What are the following heights: Ceiling: Containment:

  • What floor is equipment to be installed?

  • Is a floor plan available?

  • If yes, is the rack location marked on the floor plan?

  • If the rack location is not marked, mark the location on the floor plan!

  • Floor Plan

  • If no floor plan is available provide description of rack location!

  • Is there sufficient clearance around the racks for maintenance access; at least 24 in. ( 61 cm ) in front of and behind the rack? If yes please select each location where applicable:

  • Are installation locations clear of obstructions?

  • If no, list any permanent obstructions and mark floor plan!

  • Photo of Location 1

  • Proposed Route to location 1

  • Photo of Location 2

  • Proposed Route to location 2

  • Photo of Location 3

  • Proposed Route to location 3

  • Photo of Location 4

  • Proposed Route to location 4

  • Photo of Location 5

  • Proposed Route to location 5

  • Photo of Location 6

  • Proposed Route to location 6

  • Photo of Existing Power & Data Sockets

Pillars

  • Photo of Pillar, if location is against a pillar

Suggestions

  • If for some reason the designed location isn't working please work together with head coach and document secondary locations including description below!

  • Photo of secondary locations if required.

  • Photo of secondary locations if required.

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.