Title Page

  • Conducted on

  • Prepared by

  • Location
  • Client / Site

  • Site Contact Name

  • Site Contact Phone Number

  • Site Contact Mobile Number

  • Site Contact email

Is Wifi available for use on site?

  • Yes

  • Wifi Network

  • Wifi Password

  • No

Proposed Install Date

  • Select date

Project Agreement Time

  • Select date

Floor Composition

  • Concrete Slab

  • Suspended

  • Timber

  • Tarmac

Floor Covering in Bay

  • Carpet

  • Carpet Tiles

  • Rubber / Wet Pour

  • Paint

  • None

Floor Covering in Walkway

  • Carpet

  • Carpet Tiles

  • Rubber / Wet Pour

  • Paint

  • None

Bay Divider Type

  • Net

  • Solid Wood

  • Metal

  • None

  • Other

Bay Divider to be Moved

  • Yes

  • No

External Netting

  • Yes

  • No

Does the wood need replacing?

  • Yes

Bay Width

Bay Depth

Bay Height

Vehicle Access for Wood

  • Stated where can gain access

Cutting Area

  • State where can cut wood

Stain Type

Is a cherry picker required for lifting wood if 2 Tier

  • Yes

  • No

Location to store wood

  • No

Water Pressure

  • Good

  • Bad

Water Location

  • Metres from Bays

Vehicles Available on Site for PT use

  • Mule

  • Tractor

  • Trailer

  • None

  • Other

Images

  • Walkway

  • Bay Divider

  • Trenching

  • Entrance

  • Depth

  • Stantions

Van Parking

  • Metres from Bays

Power Supply

  • Metres from Bays

Power Socket Locations

  • State where sockets are located

Lights / Timer Socket

Trenching or Trunking

  • Trunking Colour

Skip Required

  • Yes

  • No

Skip Location

  • Metres from Bays

Site Storage Security

  • Yes

  • No

Storage Location

  • State where secure storage is available

Which Bays to Automate

  • Bay Numbers

Reopen Bays in Evening

  • Yes

  • Opening Hours:

  • No

Old Mats

  • Customer would like to keep old mats

Number of Power Tees Agreed

Additional Information / Instructions

Authorised

  • Add signature

  • Position

  • Select date

Power Tee Details

Qty of Power Tee

  • Qty of RH Power Tee

  • Qty of LH Power Tee

  • Qty of DBL Power Tee

Spares

  • Qty of Spare RH Control Panels

  • Qty of Spare LH Control Panels

  • Qty of Spare Ball Engines & Carry Case

  • Qty of Power Supplies (1 per range unless over 12 bays)

  • Qty of Complete Toolboxes

  • Additional Parts for Toolkit (over 10 bays)

  • Qty of Marketing Banners

Other Details

  • Control Panel Stand Covers Required?

  • Control Panel Design

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.