Premises Details

  • Job Sheet No.

  • Premises Name

  • Address
  • Premises Alias

  • GPS Details

  • Email

  • Conducted on

  • Prepared by

Registered Owner's Details

Building Description

  • Number of significant buildings

  • Is the building close to other sites/buildings

  • Is the premises in a rural location

  • Number of floors

  • Is there a basement

  • Floors below

  • Access Code

  • Premises Floor Area in mtr. sq.

Registered Owner Details

  • Registered Address of Owner
  • Owner's Telephone Number

Contact Person Details

Contact Persons Details

  • Contact Name

  • Position

  • Email address

  • Phone Day

  • Mobile

  • Contact Name

  • Position

  • Email address

  • Phone Day

  • Mobile

  • Contact Name

  • Position

  • Email address

  • Phone Day

  • Contact Name

  • Mobile

  • Contact Name

  • Position

  • Email address

  • Phone Day

  • Mobile

Occupancy Details

Total Occupancy Weekday

  • 09.00 - 18.00

  • 18.00 - 09.00

Total Occupancy Weekend

  • 09.00 - 18.00

  • 18.00 - 09.00

Sleeping Weekday

  • 09.00 - 18.00

  • 18.00 - 09.00

Sleeping Weekend

  • 09.00 - 18.00

  • 18.00 - 09.00

Staff Weekday

  • 09.00 - 18.00

  • 18.00 - 09.00

Staff Weekend

  • 09.00 - 18.00

  • 18.00 - 09.00

  • Number of occupancy non-ambulant

Building/Premises Details

  • Internal Communications

  • Details

  • Intercepter Tanks

  • Details

  • On-site Treatment Plant

  • Details

  • Control/Comms Room

  • Details

Sprinkler System

  • Is there a sprinkler system installed

  • Type/Location

  • Location of Stop Valve

  • Details of water supply

Drencher System

  • Is there a drencher system installed

  • Type/Location

  • Location details

  • Valve location details

  • Details of water supply

Inert Gas System

  • Is there an inert gas system installed

  • Type/Location

  • Controls location

  • Ventilation Details

Fire Fighting Facilities

  • Dry Riser

  • Details

  • Foam Inlet

  • Details

  • Static Storage

  • Details

  • Water Retention System

  • Details

  • Wet Riser

  • Details

  • First aid fire fighting equipment

  • Details

  • Fire Extinguishers

  • Locations/type

  • Fire fighting lifts

  • Details

  • Fire fighting shafts

  • Details

  • Fixed fire fighting share

Smoke Control

  • Natural Ventilation

  • Details

  • Mechanical Ventilation

  • Details

  • Controls Location

Automatic Fire Alarm System

  • System Installed

  • Type specify

  • Is the system maintained

  • By whom

  • Is the system monitored

  • By whom

  • Location of control panel

  • Location of repeater panel

  • Location of repeater panel

  • Location of repeater panel

  • Location of repeater panel

  • Location of repeater panel

  • Location of repeater panel

  • Location of repeater panel

  • Location of repeater panel

Water Supplies/Hydrants

  • Posittion

  • Size of main (mm)

  • Water Proviider

  • Is there static storage

  • Static storage capacity

  • Is there a ring main

  • Ring maim pressure (bar)

Security systems

  • Smoke cloak system

  • Dogs

  • CCTV

  • Intruder Alarms

  • Security personnel

  • Secured and left

Potential Loss/Risk

  • Sole trader

  • Details

  • Exceptional value

  • Details

  • Heritage risk

  • Details/Salvage priorities

  • Community loss

  • Details

Services and Shut off locations

  • Electricity

  • Shut off location

  • Gas

  • Shut off location

  • Oil

  • Shut off location

Hazardous Processes

  • Large Cold Rooms

  • Plant or machinery through floors in the building

  • Internal refuse chute

  • Lasers

  • Waste disposal site

  • Machinery hazard

  • Electricity supply above 415V

  • Electromagnetic radiation

  • Grain storage

  • Dust extraction system

  • Explosive hazard

  • Other specify

Salvage Priorities

  • List any salvage priorities and locations

Site Access

  • Preferred site access

  • Location

  • Access/egress difficulties

  • Location

Completed by

  • Name

  • Date

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.