Ramp C - Bollard Inspection Report

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

RAMP C - Bollard Visual Inspection

• Bollard individual Visual Inspection

Visual Bollard

• Take a picture of Bollard.

  Media

• Enter condition of Bollard, is there any damage or scratches on the bollard or bollard sleeve?

  Damaged

  Scratches

  Good Condition

• Is bollard or bollard sleeve Lose?

  Yes

  No

  N/A

• Check bollard Cover plate / Deck Plate.

  Damaged

  Missing

  Good Condition

• Verify Hole for Manual Operation on Deck / Cover Plate.

  Missing Holes

  Holes Present

• Verify Hole Cap/Cover for Manual operation hole.

  Missing

  Installed

• Verify that Rings were re-orientated to proper orientation.

  Yes

  No

  N/A

• Enter any Comments

Ramp C - EPU Inspection

• Is EPU Enclosure located in a Secure or Controlled Access Room or Closet? Enter location/room number if allowed.

  Yes

  No

  N/A

• Does the EPU Enclosure have a lock to secure?

  Yes

  No

  N/A

• Take a picture of the EPU Enclosure; Comment on Condition.

  Media

• Enter any Comments for EPU.

Ramp C - Power

• Are the Gate Arms connected to UPS

  Yes

  No

  N/A

• Verify Power Source and Power Wiring Route. (Take Pictures if Possible, of Power Connection/Termination and Wire Routing)

  Verified/Identified

  Un-Identifed

• Enter any comments for Power.

• Take Additional Pictures if Needed.

  Media

Ramp C - Bollard Operation

• Verify Bollard operation during "NORMAL" IN/Open/Un-Secure Sequence.

  Passed

  Failed

  N/A

• Verify/Test Bollard operation during "NORMAL" Out/Open/Un-Secure Sequence.

  Passed

  Failed

  N/A

• Verify/Test Bollard operation during "EFO" Sequence.

  Yes

  No

  N/A

• Enter any comments for Bollard Operation.

Ramp C - Control Panel/Touch Screen

• Test/Verify ALL Buttons on Control Panel / Touch Screen.

  Passed

  Failed

  N/A

• Test/Verify ALL Manual Buttons on Control panel / Touch Screen. (RESET, POWER ON/OFF)

  Passed

  Failed

  N/A

• Test/Verify ALL LIGHTS on Control Panel / Touch Screen are working.

  Passed

  Failed

  N/A

• Verify Alarm/Buzzer/Piezo is Audible.

  Passed

  Failed

  N/A

• Enter Any comments for Control panels / Touch Screens.

• Take Additional Pictures if Needed for Control / Touch Screen Panel.

  Media

Ramp C - Loop Detectors

• Are Loop Detectors connected to Local Gate Arm Controller?

  Yes

  No

  N/A

• Enter Any Comments for Loop Detectors.

ELECTRONIC SIGNATURE ACKNOWLEDGE, I AGREE THAT MY ELECTRONIC SIGNATURE IS A LEGALLY BINDING EQUIVALENT TO MY HANDWRITTEN SIGNATURE.

• End User / Authorized Representative

  Sign

• Nasatka Representative

  Sign