Title Page

  • RMA form sequential reference number:

  • Date of Issue:

  • Company Name:

  • Approved Maintainer's name:

  • Approved Maintainer's number:

  • Maintenance Job Reference:

  • Customer:

  • Site Address:

  • Location:

Declaration:

  • Declaration: I declare that the work undertaken fully complies with the requirements of the Q-Mark Fire Door Maintenance scheme and that the work undertaken complies with Regulation 4 and 7 of the Building Regulations for England and Wales or in accordance with the local regulations in force at the specific job site location.

Survey and Inspection

  • Sign here to confirm completion of doorset surveys and inspections

Maintenance

  • Sign to confirm completion of doorset maintenance

    Door Number
  • Door Ref

  • Location of Maintained Door

  • Client Declared Resistance Period

  • Grade Label Fitted

Description of Damage

  • The supporting structure is suitable?

  • Single or Double Door?

  • Size:

  • Size:

  • Is the door fully accessible?

  • Finish:

  • Grain:

  • Add media

  • Colour:

  • The frame is suitable and in good condition?

  • Frame configuration:

  • The overpanel/side panel is suitable and in good condition?

  • There is sufficient fire stopping behind the frame?

  • The architrave is suitable and in good condition?

  • The door stops are suitable and in good condition?

  • The door leaf is suitable and free from damage?

  • The gaps around the door are between 2 and 4mm?

  • The gap under the door is no greater than 10mm or 3mm for doors that require smoke control?

  • COMBINED OR SEPARATE SEALS?

  • Intumescent is present, suitable and undamaged?

  • Intumescent/smoke seal is present, suitable and undamaged?

  • Intumescent is present, suitable and undamaged?

  • Smoke seals are present, suitable and undamaged?

  • Smoke seals are present, suitable and undamaged?

  • Is intumescent required?

  • Drop down threshold seal is present and working?

  • Correct number of hinges present, certified and in good condition?

  • The glazing system is suitable and in good condition?

  • Door closer is present, working and in good condition?

  • Door closes correctly (90° & 5°) and latches where required?

  • Hardware is present, suitable, operates correctly and is in good condition?

  • Door is correctly signed?

  • Air transfer grill is suitable and correctly fitted?

  • Is an electrical security lock fitted?

  • Is it correctly installed?

  • Does the door release work?

  • Does the emergency release work

  • Does certification allow bolt-thru (mag-lock) or cable run (electro magnetic latch) installation ?

  • Emergency exit device is present and working?

  • Hold open device operates correctly?

  • Escape route is clear of obstructions and is accessible

  • Pass/Fail

  • Comments:

  • Notes:

  • ART's Required

  • Size:

  • Size:

  • Are both leaves fully accessible?

  • Finish:

  • Grain:

  • Add media

  • Colour:

  • The frame is suitable and in good condition?

  • Frame configuration:

  • The overpanel/side panel is suitable and in good condition?

  • There is sufficient fire stopping behind the frame?

  • The architrave is suitable and in good condition?

  • The door stops are suitable and in good condition?

  • The door leaves are suitable and free from damage?

  • The gaps around the door are between 2 and 4mm?

  • The gap under the door is no greater than 10mm or 3mm for doors that require smoke control?

  • COMBINED OR SEPARATE SEALS?

  • Intumescent is present, suitable and undamaged?

  • Intumescent is present, suitable and undamaged to the closing edge?

  • Intumescent is present, suitable and undamaged?

  • Smoke seal is present, suitable and undamaged?

  • Intumescent/Smoke seal is present, suitable, undamaged and correctly installed to the closing edge?

  • Intumescent/Smoke seals are present, suitable and undamaged?

  • Intumescent/Smoke seal is present, suitable, undamaged and correctly installed to the closing edge?

  • Smoke seal is present, suitable and undamaged?

  • Smoke seal is present, suitable, undamaged and correctly installed to the closing edge?

  • Is intumescent required?

  • Drop down threshold seal is present and working?

  • Correct number of hinges present, certified and in good condition?

  • The glazing system is suitable and in good condition?

  • Door closer is present, working and in good condition?

  • Door closes correctly (90° & 5°) and latches where required?

  • Hardware is present, suitable, operates correctly and is in good condition?

  • Are the secondary leaf bolts present, suitable, operate correctly and in good condition?

  • Door is correctly signed?

  • Air transfer grill is suitable and correctly fitted?

  • Is an electrical security lock fitted?

  • Is it correctly installed?

  • Does the door release work?

  • Does the emergency release work

  • Does certification allow bolt-thru (mag-lock) or cable run (electro magnetic latch) installation ?

  • Emergency exit device is present and working?

  • Hold open device operates correctly?

  • Escape route is clear of obstructions and is accessible

  • Pass/Fail

  • Comments:

  • Notes:

  • ART's Required

Maintenance

  • Maintenance & Required ART's Completed

  • Issue's completed

  • ART's used

  • Maintenance Date

  • Maintained by

  • Next Maintenance Date

Pictures before Maintenance

  • Add media

Pictures after Maintenance

  • Add media

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