Preventive Maintenance - Automatic Door [ Swing ]

• Conducted on

  Date

• Authorised Technician

• Technician ADSA Number

• Job Number

• Customer

  Co-operative Group

• Site Name

• Post Code

Asset Inspection:

• Door Location

  Select Entrance - Main Entrance - Side Entrance - Rear Exit - Main Exit - Slide Exit - Rear Internal - Entrance Internal - Exit Internal - Warehouse Internal - Shop Floor

  • Entrance - Main
  • Entrance - Side
  • Entrance - Rear
  • Exit - Main
  • Exit - Slide
  • Exit - Rear
  • Internal - Entrance
  • Internal - Exit
  • Internal - Warehouse
  • Internal - Shop Floor

• Manufacture

  Select FAAC RECORD TORMAX DORMA GEZE HORTON ASSA ABLOY GILGEN OTHER

  • FAAC
  • RECORD
  • TORMAX
  • DORMA
  • GEZE
  • HORTON
  • ASSA ABLOY
  • GILGEN
  • OTHER

• Manufacture Name

• Door Type

  Single Swing

  Double Swing

• Image - Asset

  Media

• Image - Asset No [Sticker]

  Media

Opening & Closing Forces Static Entrapment

• Opening Force [ Newton ] - Should be <150 N

• Closing Force [ Newton ] - Should be <150 N

Door Speeds and Energies

• Ensure all speeds and powers are set to comply to BS EN 16005 or BS 7036

• Opening Time [ Seconds ]

• Closing Time [ Seconds ]

• Hold Open [ Seconds ]

• Clear Opening [ mm ]

Activation Detection Zones

• Inner Radar

• Inner Radar - Straight Approach

  Yes

  No

• Distance[ mm ]

• Inner Radar - Side Approach

  Yes

  No

• Distance [ mm ]

• Outer Radar

• Outer Radar - Straight Approach

  Yes

  No

• Distance [ mm ]

• Outer Radar - Side Approach

  Yes

  No

• Distance [ mm ]

Safety Sensor Detection Zones

• Threshold Area/Closing direction Swept Area

• Field Width

  Yes

  No

• Size [ mm ]

• Field Depth

  Yes

  No

• Size [ mm ]

• Monitored

  Yes

  No

• Rear Edge Area/Opening Direction Swept Area

• Field Width [ mm ]

  Yes

  No

• Size [ mm ]

• Field Depth [ mm ]

  Yes

  No

• Size [ mm ]

• Sensor Action

  Slows

  Stops

  Audible warning

  Other

• Comments

  Yes

  No

  N/A

• Monitored

  Yes

  No

Mechanical and Hinge Protection

• Fingerguard

  Yes

  No

• Barriers

  Yes

  No

• ESPE Hinge protection

  Yes

  No

• Construction Gaps

  Yes

  No

Escape System

• Power outage Door Fails?

  Open

  Closed

  No

• Why?

• Door reaction on faults

  Open

  Closed

  No

• Why?

• Break Out fitted

  Yes

  No

• Force required to break Out [ N ] - Should not exceed 220N

Door Signage

• Automatic Door

  Yes

  No

• Total

  Select 1 2 3 4 5 6

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6

• Directional Arrow

  Yes

  No

• Total

  Select 1 2 3 4 5 6

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6

• Keep Clear

  Yes

  No

• Total

  Select 1 2 3 4 5 6

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6

• No Entry/Exit

  Yes

  No

• Total

  Select 1 2 3 4 5 6

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6

• Breakout

  Yes

  No

• Total

  Select 1 2 3 4 5 6

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6

• Disability sign

  Yes

  No

• Total

  Select 1 2 3 4 5 6

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6

• Push button to open

  Yes

  No

• Total

  Select 1 2 3 4 5 6

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6

• Access controlled door

  Yes

  No

• Total

  Select 1 2 3 4 5 6

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6

Additional Check List

• Program switch lockout tested

  Yes

  No

  N/A

• Occupiers’ safety check recorded

  Yes

  No

  N/A

• Locks Checked

  Yes

  No

  N/A

• Fire alarm - Conected?

  Select Yes No

  • Yes
  • No

• Comments

Conformity

• Standard

  BS 7036

  EN 16005 2012

• Asset Compliant

  Yes

  No

• Why does door not comply?

• Asset compliant

  Yes

  No

• Why does door not comply?

PUWER Regulation 4: Suitability of work equipment

• Is the equipment suitable for the purpose for which it is used or provided?

  Yes

  N/A - Manual

  No

• Please explain why the equipment is not suitable?

PUWER Regulation 5: Maintenance

• Is the equipment maintained in an efficient state; in efficient working order and in good repair?

  Yes

  N/A - Manual

  No

• Engineer Recommendations:

• Where the equipment has a maintenance log, has it been kept up to date?

  Yes

  N/A - Manual

  No

PUWER Regulation 6: Inspection

• Is the equipment inspected regularly and are records kept of these inspections?

  Yes

  No

PUWER Regulation 7: Specific Risks

• Equipment Operation: Does the equipment or parts of the equipment pose specific risks which mean that it's operation needs to be restricted to suitably trained persons?

  Yes

  No

  N/A

• Can those operating the equipment evidence they are competent to do so?

  Yes

  No

• Equipment Maintenance: Does the equipment or parts of the equipment pose specific risks which mean that it's maintenance needs to be restricted to suitably trained persons?

  Yes

  No

  N/A

• Maintenance must always be carried out by the contracted and competent contractor.

• Is this equipment/machine or parts of the equipment/machine guarded/provide prevention of use/access by untrained persons? (example: access coded)

  Yes

  N/A - Manual

  No

PUWER Regulation 8: Information

• Do all persons who use the equipment have access to the equipment's user manual?

  Yes

  No

PUWER Regulation 9: Training

• Has a responsible person on site been shown how to correctly operate the equipment/asset; with all associated risks explained and precautions detailed in order to avoid/minimise these risks?

  Yes

  No

PUWER Regulation 10: Conformity with EU Directives

• Does the asset/equipment have a CE Mark?

  Yes

  No

PUWER Regulation 11: Dangerous parts of machinery

• Are there any unguarded hazards?

  Yes

  No

• Please identify the unguarded hazards and preventative actions required?

• Image of the hazard

  Media

PUWER Regulation 12: Protection against specified hazards

• Is the design of the equipment fit for purpose (consider domestic/commercial/industrial use)

  Yes

  No

• Please explain why the design is not fit for purpose?

PUWER Regulation 14: Controls for starting and making a significant change in operating conditions

• Do the controls for starting the equipment, controlling speed, pressure or other operating conditions require a deliberate action? (Example: to modify the setup/change the parameters of an auto door, or the limits to a shutter)

  Yes

  No

• Comment

PUWER Regulation 15: Stop controls

• Is the equipment provided with one or more readily accessible controls which bring the equipment to a safe condition in a safe manner?

  Yes

  N/A - Manual

  No

• Is power disconnected to actuators after the equipment comes to a stop?

  Yes

  N/A - Manual

  No

• Does the stop command have priority over the start command?

  Yes

  N/A - Manual

  No

• Comments

PUWER Regulation 16: Emergency stop controls

• Emergency stop controls are not required for hand held or hand guided machines or for machines which stop quickly using the stop control

• Does this equipment require an emergency stop control?

  Yes

  No

  N/A

• Does this equipment have one or more emergency stop controls?

  Yes

  N/A - Manual

  No

• Please describe all remedial action required?

• Please contact the office for approval to decommission the asset

PUWER Regulation 17: Controls

• Are all controls clearly visible and identifiable?

  Yes

  No

  N/A

• Are the controls in a danger zone?

  Yes

  No

• Image of controls

  Media

• Recommendation for re-location of controls

• Are the controls positioned where it is possible to see if anyone is in the danger zone? (Example: under a shutter when it is being lowered)

  No

  Yes

• Is there a safe system of work in place to prevent any persons being in the danger zone when the equipment is being operated

  Yes

  No

  N/A

• Comments

  Yes

  No

PUWER Regulation 19: Isolation from sources of energy

• Can the fused spur be isolated/fuse removed before the engineer starts any works on the asset?

  Yes

  N/A - Manual

  No

• Comments:

PUWER Regulation 20: Stability

• Is the work equipment sufficiently stabilised? (example: shutter guide stability)

  Yes

  No

• Please provide any recommendations to sufficiently stabilise the equipment

• Please provide photographic evidence of stability risk

  Media

PUWER Regulation 21: Lighting

• Has suitable and sufficient lighting been provided to safely use and maintain the equipment?

  Yes

  No

• Recommendations

PUWER Regulation 22: Maintenance operations

• Can maintenance operations be carried out whilst the equipment is shut down?

  Yes

  No

  N/A - Manual

• Can maintenance operations be carried out without exposing the person carrying them out to risk?

  Yes

  No

  N/A - Manual

• Can maintenance operations which involve risk be carried out safely if appropriate measures are taken to protect the person carrying out the work?

  Yes

  No

• Please identify the control measures required to safely carry out maintenance on the equipment

• DO NOT PROCEED WITH MAINTENANCE

• Recommendations to improve safety to allow for maintenance operations

PUWER Regulation 23: Markings

• Is the equipment marked in a clearly visible manner with any markings appropriate for reasons of health and safety?

  Yes

  N/A - Manual

  No

• Comments

  Yes

  N/A - Manual

  No

PUWER Regulation 24: Warnings

• Does the equipment incorporate any warnings or warning devices which are appropriate for reasons of health and safety?

  Yes

  No

• Are the warnings given by warning devices unambiguous, easily perceived and easily understood?

  Yes

  No

• Are warnings or warning devices required?

  Yes

  No

• Please describe the warnings/warning devices required?

• Client

  Sign

• Engineer

  Sign