Information

  • EVR Number:

  • Client:

  • Site:

  • Project Number :

  • Prepared on:

  • Location:
  • Prepared by:

  • Prepared by Signature:

Introduction

  • This Electrical Validation Report (EVR) is an overview of the existing electrical installation carried out by RMS LTD. It has been carried out in-line with BS7671:Amendment 3 20015

    Please note that the items listed within this report are as noted at the time of inspection.

  • The attached report presents findings of a visual and intrusive survey of the electrical Installation at:

  • Excluded from this report:

  • Inspection start date:

  • This report provides a representation of the condition of the electrical installation on the following floors/areas:

Summary

  • Summary includes:

  • SUPPLY CHARACTERISTICS/INTAKE (ORIGIN)

  • SUPPLY CHARACTERISTICS/INTAKE (ORIGIN) SUMMARY

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  • EARTHING & BONDING SUMMARY

  • EARTHING & BONDING SUMMARY

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  • SWITCH GEAR & METERING SUMMARY

  • SWITCH GEAR & METERING SUMMARY

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  • SUB-MAINS SUMMARY

  • SUB-MAINS SUMMARY

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  • DISTRIBUTION BOARD SUMMARY

  • DISTRIBUTION BOARD SUMMARY

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  • SMALL POWER SYSTEM SUMMARY

  • SMALL POWER SYSTEM SUMMARY

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  • LIGHTING SYSTEM SUMMARY

  • LIGHTING SYSTEM SUMMARY

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  • DATA SYSTEM SUMMARY

  • DATA SYSTEM SUMMARY

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  • FIRE ALARM SYSTEM SUMMARY

  • FIRE ALARM SYSTEM SUMMARY

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  • DOOR ENTRY SYSTEM SUMMARY

  • DOOR ENTRY SYSTEM SUMMARY

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  • SECURITY ALARM SYSTEM SUMMARY

  • SECURITY ALARM SYSTEM SUMMARY

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  • AV SYSTEM SUMMARY

  • AV SYSTEM SUMMARY

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  • PA SYSTEM SUMMARY

  • PA SYSTEM SUMMARY

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  • ELECTRICAL RISER SUMMARY

  • PA SYSTEM SUMMARY

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  • LIFT MOTOR ROOM SUMMARY

  • LIFT MOTOR ROOM SUMMARY

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  • PLANT ROOM SUMMARY

  • PLANT ROOM SUMMARY

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  • CONTAINMENT SUMMARY

  • CONTAINMENT SUMMARY

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  • HIGH LEVEL/CEILING SURVEY SUMMARY

  • HIGH LEVEL/CEILING SUMMARY

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  • LOW LEVEL/FLOOR SURVEY SUMMARY

  • LOW LEVEL/FLOOR SURVEY SUMMARY

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  • LOW LEVEL/FLOOR SURVEY SUMMARY

  • LOW LEVEL/FLOOR SURVEY SUMMARY

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  • RECOMMENDATIONS

Supply Characteristics/Intake (Origin)

  • Incoming Supply Characteristic/Intake (Origin) Surveyed:

  • Nature of supply parameters by:

  • Incoming Supply Cable Size:

  • Incoming Supply Cable Size:

  • Incoming Supply Cable Conductor Material:

  • Incoming Supply Conductor Material:

  • Incoming Supply Voltage:

  • Incoming Supply Voltage:

  • Ze Reading Recorded:

  • Ze Reading recorded or Reason for being unable to record a result:

  • Is Existing Certificate Available?

  • Existing Certificate No:

  • Photo of Certificate

  • Main Switch/Fuse type:

  • Main Switch/Fuse Type:

  • Main Switch/Fuse No. of poles:

  • Main Switch/Fuse Voltage Rating:

  • Main Switch/Fuse Voltage Rating:

  • Main Switch/Fuse Current Rating:

  • Main Switch/Fuse Current Rating

  • Main Switch/Fuse Short Circuit Capacity:

  • Condition of Service Cables:

  • Reason For Unsatisfactory Condition:

  • Photo of Unsatisfactory Service Cables:

  • Condition of Service head:

  • Reason For Unsatisfactory Condition:

  • Photo of Unsatisfactory Service head:

  • Condition of Meter tails:

  • Reason For Unsatisfactory Condition:

  • Photo of Unsatisfactory Meter tails:

  • Condition of Metering equipment:

  • Reason For Unsatisfactory Condition:

  • Photo of Unsatisfactory Metering equipment:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

Earthing and Bonding

  • Main Earthing and Bonding Surveyed:

  • Earthing System:

  • Main Earthing Conductor Material:

  • Main Earthing Conductor Material:

  • Main Earthing Conductor Size:

  • Main Earthing Conductor Size:

  • Main Protective Bonding Conductors:

  • Water Installation Pipe Conductor Material:

  • Conductor Material:

  • Water Installation Pipe Conductor Size:

  • Conductor Size:

  • Oil Installation Pipe Conductor Material:

  • Conductor Material:

  • Oil Installation Pipe Conductor Size:

  • Conductor Size:

  • Gas Installation Pipe Conductor Material:

  • Conductor Material:

  • Gas Installation Pipe Conductor Size:

  • Conductor Size:

  • Structural Steel Conductor Material:

  • Conductor Material:

  • Structural Steel Conductor Size:

  • Conductor Size:

  • Lightning Protection Conductor Material:

  • Conductor Material:

  • Lightning Protection Conductor Size:

  • Conductor Size:

  • Main Protective Bonding Conductor
  • Main Protective Bonding Conductor

  • Conductor Material:

  • Conductor Material:

  • Conductor Size:

  • Conductor Size:

  • EQUIPOTENTIAL PROTECTIVE BONDING CONDUCTORS:

  • EQUIPOTENTIAL PROTECTIVE BONDING CONDUCTOR
  • EQUIPOTENTIAL PROTECTIVE BONDING CONDUCTOR

  • Conductor Material:

  • Conductor Material:

  • Conductor Size:

  • Conductor Size:

  • Condition Of Main Earthing Conductor (Cable, Crimps, Earthing Bar/Bolts)

  • Reason for Un-Satisfactory Condition:

  • Photo of Un-Satisfactory Main Earthing Conductor:

  • Condition Of Main Protective Bonding Conductors (Cable, Crimps, Earthing Bar/Bolts, Clamps)

  • Un-Satisfactory Main Protective Bonding Conductor
  • Reason for Un-Satisfactory Condition:

  • Photo of Un-Satisfactory Main Protective Bonding Conductor:

  • Condition Of EQUIPOTENTIAL PROTECTIVE BONDING CONDUCTORS (Cable, Crimps, Earthing Bar/Bolts, Clamps)

  • Unsatisfactory Equipotential Protective Bonding Conductor:
  • Reason for Un-Satisfactory Condition:

  • Photo of Un-Satisfactory Equipotential Protective Bonding Conductor:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

Mains Distribution Panels, Switch Gear, Metering & Sub-Mains

    Mains Distribution Panels, Switch Gear, Metering & Sub Mains Survey:
  • Main Distribution Panel Surveyed:

  • Panel Designation:

  • Panel Location:

  • Panel Manufacturer:

  • Panel Model:

  • Panel Mounting:

  • Incoming Panel Over Current Protective Device/Switch:

  • Over Current Protective Device:

  • Number of Poles:

  • Rating Amps:

  • Rating Amps:

  • Type No.

  • Short Circuit Capacity:

  • Short Circuit Capacity:

  • Number of Ways in Panel:

  • Number of Ways in Panel Being Used:

  • Over Current Protective Device used in Panel:

  • Over Current Protective Device:

  • Number of Ways in Panel Spare:

  • Over Current Protective Device:

  • Over Current Protective Device:

  • Rating Amps:

  • Rating Amps:

  • Type No.

  • Short Circuit Capacity:

  • Short Circuit Capacity:

  • Number of Spares with Main Switches Installed:

  • Condition Of Panel:

  • Reason For Un-Satisfactory Condition:

  • Photo of Un-Satisfactory Panel:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Metering Surveyed:

  • Number of Meters:

  • Number of Meters Surveyed:

  • Meter Manufacturer:

  • Mater Model:

  • Condition Of Meter:

  • Reason For Un-Satisfactory Condition:

  • Photo of Un-Satisfactory Meter:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Switch Gear Surveyed:

  • Switch Gear Manufacturer:

  • Switch Gear Model:

  • Switch Gear Designation:

  • Switch Gear Fused or Un-fused:

  • Switch Gear Rating:

  • Switch Gear Rating Amps:

  • Switch Gear Fuse Rating:

  • Switch Gear Fuse Rating Amps:

  • Type of Switch Fuse:

  • Type of Switch Fuse:

  • Condition Of

  • Reason For Un-Satisfactory Condition:

  • Photo of Un-Satisfactory

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Sub Mains Surveyed:

  • Number of Sub Mains within Panel/ Switch Gear:

  • Number of Sub Mains Surveyed:

  • Number of Sub Mains Tested:

  • Previous Test Certificates Available:

  • Picture of Test Certificates:

  • Sub Main Information:

  • Sub Main
  • Designation:

  • Load Connection Location:

  • Over Current Protective Device:

  • Over Current Protective Device:

  • Over Current Protective Device:

  • Rating Amps:

  • Over Current Protective Device:

  • Type No.

  • Short Circuit Capacity:

  • Over Current Protective Device:

  • Supply connection Location:

  • Age of Cable in Years:

  • Cable Size:

  • Cable Size

  • Number of Cores:

  • Cable Type:

  • Cable Type

  • Installation Reference Method:

  • Installation Reference Method:

Distribution Boards

  • Distribution Boards Surveyed

  • How Many Distribution Boards are Installed?

  • Distribution Board

  • DB
  • DB Location:

  • DB Designation:

  • DB Manufacturer:

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  • DB Model:

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  • DB Number of Phases:

  • DB Main Switch Type:

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  • Main Switch Number of Poles:

  • Main Switch Current Rating:

  • Main Switch Voltage Rating:

  • Is DB Condition Satisfactory:

  • Summary of DB Defects:

  • Photo of Defects

  • Is DB Circuit Schedule Present and Up to Date:

  • Photo of Circuit Schedule:

  • Is there Adequate Protective Devices Installed:

  • Photo of RCD/RCBO

  • Photo of MCB

  • Existing Circuits Installed:

  • Is an up to Date Test Certificate Available:

  • Photo of Relevant Test Certificate:

  • Are any of the Existing Circuits outside of the contract area affected by works to be carried out

  • Existing Circuits outside of the contract Area affected by works to be carried out:

  • Photo of Circuits outside

  • Is any of the Existing circuits Unknown:

  • Information raised about Existing Unknown Circuits:

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  • Tests Results Recorded:

  • Photo of test Results:

  • Test Results/Additional Information:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Additional Photos:

  • Add Additional Photos:
  • Additional Photos:

Small Power System

  • Small Power System Surveyed:

  • Small Power Circuits Surveyed:

  • Circuit Designation:

  • Circuit Description:

  • Type of Wiring:

  • R1/L & RN/N Size:

  • R2/CPC Size

  • Over Current Protective Device:

  • Over Current Protective Device Amp Rating:

  • Number of Points Served:

  • Is Condition Satisfactory:

  • Photo:
  • Insert Photo:

  • Reason for Unsatisfactory Condition:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Photo:

  • Additional Information:

  • Existing Testing/Commissioning Certificate available;

  • Photo of Certificate:

  • Test Results Recorded:

  • Photo:

  • Test Results/Additional Information:

  • Small Power Accessories surveyed:

  • Fitting Manufacturer:

  • Fitting type:

  • Number installed:

  • Location Installed:

  • Type of Wiring:

  • Attach photo

  • Is Condition Satisfactory:

  • Reason for Unsatisfactory Condition:

  • Photo:
  • Insert Photo:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Photo:

  • Additional Information:

  • Existing Testing/Commissioning Certificate available;

  • Photo of Certificate:

  • Additional Information:

  • Test Results Recorded:

  • Photo:

  • Test Results/Additional Information:

Lighting System

  • Lighting System Surveyed:

  • Lighting Circuits Surveyed:

  • Circuit Designation:

  • Circuit Description:

  • Type of Wiring:

  • R1/L & RN/N Size:

  • R2/CPC Size

  • Over Current Protective Device:

  • Over Current Protective Device Amp Rating:

  • Number of Points Served:

  • Is Condition Satisfactory:

  • Reason for Unsatisfactory Condition:

  • Photo:
  • Insert Photo:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Photo:

  • Additional Information:

  • Existing Testing/Commissioning Certificate available;

  • Photo of Certificate:

  • Test Results Recorded:

  • Photo:

  • Test Results/Additional Information:

  • Light Fittings surveyed:

  • Fitting Manufacturer:

  • Fitting type:

  • Lamp Type:

  • Number installed:

  • Location Installed:

  • Type of Wiring:

  • Attach photo

  • Is Condition Satisfactory:

  • Reason for Unsatisfactory Condition:

  • Photo:
  • Insert Photo:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Photo:

  • Additional Information:

  • Existing Testing/Commissioning Certificate available;

  • Photo of Certificate:

  • Test Results Recorded:

  • Photo:

  • Test Results/Additional Information:

  • Lighting Control System Surveyed:

  • Lighting Control System Installed:

  • Lighting Control System Accessory:

  • Accessory Manufacturer:

  • Accessory type:

  • Number installed:

  • Location Installed:

  • Type of Wiring:

  • Attach photo

  • Is Condition Satisfactory:

  • Reason for Unsatisfactory Condition:

  • Photo:
  • Insert Photo:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Photo:

  • Additional Information:

  • Existing Testing/Commissioning Certificate available;

  • Photo of Certificate:

  • Additional Information:

  • Test Results Recorded:

  • Photo:

  • Test Results/Additional Information:

DATA System

  • DATA System Surveyed:

  • DATA Server Surveyed:

  • DATA Server Installed:

  • DATA Server Accessory:

  • Accessory Manufacturer:

  • Accessory type:

  • Number installed:

  • Location Installed:

  • Type of Wiring:

  • Attach photo

  • Is Condition Satisfactory:

  • Photo:
  • Insert Photo:

  • Reason for Unsatisfactory Condition:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Photo:

  • Additional Information:

  • Existing Testing/Commissioning Certificate available;

  • Photo of Certificate:

  • Additional Information:

  • Test Results Recorded:

  • Photo:

  • Test Results/Additional Information:

  • DATA Circuits Surveyed:

  • Circuit Designation:

  • Circuit Description:

  • Type of Wiring:

  • Is Condition Satisfactory:

  • Reason for Unsatisfactory Condition:

  • Photo:
  • Insert Photo:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Photo:

  • Additional Information:

  • Existing Testing/Commissioning Certificate available;

  • Photo of Certificate:

  • Test Results Recorded:

  • Photo:

  • Test Results/Additional Information:

  • DATA Accessories surveyed:

  • Fitting Manufacturer:

  • Fitting type:

  • Number installed:

  • Location Installed:

  • Type of Wiring:

  • Attach photo

  • Is Condition Satisfactory:

  • Photo:
  • Insert Photo:

  • Reason for Unsatisfactory Condition:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Photo:

  • Existing Testing/Commissioning Certificate available;

  • Photo of Certificate:

  • Additional Information:

  • Test Results Recorded:

  • Photo:

  • Test Results/Additional Information:

Fire Alarm System

  • Fire Alarm System Surveyed:

  • Fire Alarm Panel Surveyed:

  • Fire Alarm Panel Installed:

  • Fire Alarm Panel:

  • Fire Alarm Panel Manufacturer:

  • Fire Alarm Panel type:

  • Number installed:

  • Location Installed:

  • Type of Wiring:

  • Fire Alarm Current Maintainer:

  • Attach photo

  • Is Condition Satisfactory:

  • Photo:
  • Insert Photo:

  • Reason for Unsatisfactory Condition:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Photo:

  • Additional Information:

  • Existing Testing/Commissioning Certificate available;

  • Photo of Certificate:

  • Additional Information:

  • Test Results Recorded:

  • Photo:

  • Test Results/Additional Information:

  • Fire Alarm Circuits Surveyed:

  • Circuit Designation:

  • Circuit Description:

  • Type of Wiring:

  • Size of Wiring:

  • Number of points Served:

  • Is Condition Satisfactory:

  • Reason for Unsatisfactory Condition:

  • Photo:
  • Insert Photo:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Photo:

  • Additional Information:

  • Existing Testing/Commissioning Certificate available;

  • Photo of Certificate:

  • Test Results Recorded:

  • Photo:

  • Test Results/Additional Information:

  • Fire Alarm Accessories surveyed:

  • Fitting Manufacturer:

  • Fitting type:

  • Number installed:

  • Location Installed:

  • Type of Wiring:

  • Attach photo

  • Is Condition Satisfactory:

  • Photo:
  • Insert Photo:

  • Reason for Unsatisfactory Condition:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Photo:

  • Existing Testing/Commissioning Certificate available;

  • Photo of Certificate:

  • Additional Information:

  • Test Results Recorded:

  • Photo:

  • Test Results/Additional Information:

Security Alarm System

  • Security Alarm System Surveyed:

  • Security Alarm Panel Surveyed:

  • Security Alarm Panel Installed:

  • Security Alarm Panel:

  • Security Alarm Panel Manufacturer:

  • Security Alarm Panel type:

  • Number installed:

  • Location Installed:

  • Type of Wiring:

  • Security Alarm Current Maintainer:

  • Attach photo

  • Is Condition Satisfactory:

  • Photo:
  • Insert Photo:

  • Reason for Unsatisfactory Condition:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Photo:

  • Additional Information:

  • Existing Testing/Commissioning Certificate available;

  • Photo of Certificate:

  • Additional Information:

  • Test Results Recorded:

  • Photo:

  • Test Results/Additional Information:

  • Security Alarm Circuits Surveyed:

  • Circuit Designation:

  • Circuit Description:

  • Type of Wiring:

  • Size of Wiring:

  • Number of points Served:

  • Is Condition Satisfactory:

  • Reason for Unsatisfactory Condition:

  • Photo:
  • Insert Photo:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Photo:

  • Additional Information:

  • Existing Testing/Commissioning Certificate available;

  • Photo of Certificate:

  • Test Results Recorded:

  • Photo:

  • Test Results/Additional Information:

  • Security Alarm Accessories surveyed:

  • Fitting Manufacturer:

  • Fitting type:

  • Number installed:

  • Location Installed:

  • Type of Wiring:

  • Attach photo

  • Is Condition Satisfactory:

  • Photo:
  • Insert Photo:

  • Reason for Unsatisfactory Condition:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Photo:

  • Existing Testing/Commissioning Certificate available;

  • Photo of Certificate:

  • Additional Information:

  • Test Results Recorded:

  • Photo:

  • Test Results/Additional Information:

Door Entry System

  • Door Entry System Surveyed:

  • Door Entry Panel Surveyed:

  • Door Entry Panel Installed:

  • Door Entry Panel:

  • Door Entry Panel Manufacturer:

  • Door Entry Panel type:

  • Number installed:

  • Location Installed:

  • Type of Wiring:

  • Door Entry System Current Maintainer:

  • Attach photo

  • Is Condition Satisfactory:

  • Photo:
  • Insert Photo:

  • Reason for Unsatisfactory Condition:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Photo:

  • Additional Information:

  • Existing Testing/Commissioning Certificate available;

  • Photo of Certificate:

  • Additional Information:

  • Test Results Recorded:

  • Photo:

  • Test Results/Additional Information:

  • Door Entry System Circuits Surveyed:

  • Circuit Designation:

  • Circuit Description:

  • Type of Wiring:

  • Size of Wiring:

  • Number of points Served:

  • Is Condition Satisfactory:

  • Reason for Unsatisfactory Condition:

  • Photo:
  • Insert Photo:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Photo:

  • Additional Information:

  • Existing Testing/Commissioning Certificate available;

  • Photo of Certificate:

  • Test Results Recorded:

  • Photo:

  • Test Results/Additional Information:

  • Door Entry Accessories surveyed:

  • Fitting Manufacturer:

  • Fitting type:

  • Number installed:

  • Location Installed:

  • Type of Wiring:

  • Attach photo

  • Is Condition Satisfactory:

  • Photo:
  • Insert Photo:

  • Reason for Unsatisfactory Condition:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Photo:

  • Existing Testing/Commissioning Certificate available;

  • Photo of Certificate:

  • Additional Information:

  • Test Results Recorded:

  • Photo:

  • Test Results/Additional Information:

AV System

  • AV System Surveyed:

  • AV System Panel Surveyed:

  • AV System Panel Installed:

  • AV System Panel:

  • AV System Panel Manufacturer:

  • AV System Panel type:

  • Number installed:

  • Location Installed:

  • Type of Wiring:

  • Door Entry System Current Maintainer:

  • Attach photo

  • Is Condition Satisfactory:

  • Photo:
  • Insert Photo:

  • Reason for Unsatisfactory Condition:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Photo:

  • Additional Information:

  • Existing Testing/Commissioning Certificate available;

  • Photo of Certificate:

  • Additional Information:

  • Test Results Recorded:

  • Photo:

  • Test Results/Additional Information:

  • AV System Circuits Surveyed:

  • Circuit Designation:

  • Circuit Description:

  • Type of Wiring:

  • Size of Wiring:

  • Number of points Served:

  • Is Condition Satisfactory:

  • Reason for Unsatisfactory Condition:

  • Photo:
  • Insert Photo:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Photo:

  • Additional Information:

  • Existing Testing/Commissioning Certificate available;

  • Photo of Certificate:

  • Test Results Recorded:

  • Photo:

  • Test Results/Additional Information:

  • AV Accessories surveyed:

  • Fitting Manufacturer:

  • Fitting type:

  • Number installed:

  • Location Installed:

  • Type of Wiring:

  • Attach photo

  • Is Condition Satisfactory:

  • Photo:
  • Insert Photo:

  • Reason for Unsatisfactory Condition:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Photo:

  • Existing Testing/Commissioning Certificate available;

  • Photo of Certificate:

  • Additional Information:

  • Test Results Recorded:

  • Photo:

  • Test Results/Additional Information:

PA System

  • PA System Surveyed:

  • PA System Panel Surveyed:

  • PA System Panel Installed:

  • PA System Panel:

  • PA System Panel Manufacturer:

  • PA System Panel type:

  • Number installed:

  • Location Installed:

  • Type of Wiring:

  • PA System Current Maintainer:

  • Attach photo

  • Is Condition Satisfactory:

  • Photo:
  • Insert Photo:

  • Reason for Unsatisfactory Condition:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Photo:

  • Additional Information:

  • Existing Testing/Commissioning Certificate available;

  • Photo of Certificate:

  • Additional Information:

  • Test Results Recorded:

  • Photo:

  • Test Results/Additional Information:

  • PA System Circuits Surveyed:

  • Circuit Designation:

  • Circuit Description:

  • Type of Wiring:

  • Size of Wiring:

  • Number of points Served:

  • Is Condition Satisfactory:

  • Reason for Unsatisfactory Condition:

  • Photo:
  • Insert Photo:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Photo:

  • Additional Information:

  • Existing Testing/Commissioning Certificate available;

  • Photo of Certificate:

  • Test Results Recorded:

  • Photo:

  • Test Results/Additional Information:

  • PA Accessories surveyed:

  • Fitting Manufacturer:

  • Fitting type:

  • Number installed:

  • Location Installed:

  • Type of Wiring:

  • Attach photo

  • Is Condition Satisfactory:

  • Photo:
  • Insert Photo:

  • Reason for Unsatisfactory Condition:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Photo:

  • Existing Testing/Commissioning Certificate available;

  • Photo of Certificate:

  • Additional Information:

  • Test Results Recorded:

  • Photo:

  • Test Results/Additional Information:

Electrical Risers

  • Electrical Risers Surveyed:

  • Details

  • LOCATION
  • Location:

  • Number of Distribution Boards Installed:

  • Other equipment installed

  • Details:

  • Photo

  • Additional Details ?

  • Additional Details

  • Item
  • Designation:

  • Purpose:

  • Observation:

  • Photo:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Add media

Lift Motor Room

  • Lift Motor Room Surveyed:

  • Details

  • LOCATION
  • Location:

  • Lift Manufacturer:

  • Current Lift Maintainer:

  • Photo:
  • Photo:

  • Relevant Information:

  • Other equipment installed

  • Details:

  • Photo

  • Additional Details ?

  • Additional Details

  • Item
  • Designation:

  • Purpose:

  • Observation:

  • Photo:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Add media

Plant Room

  • Plant Room Surveyed:

  • Details

  • LOCATION
  • Location:

  • Plant Manufacturer:

  • Current Plant Maintainer:

  • Photo:
  • Photo:

  • Relevant Information:

  • Other equipment installed

  • Details:

  • Photo

  • Additional Details ?

  • Additional Details

  • Item
  • Designation:

  • Purpose:

  • Observation:

  • Photo:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Add media

Containment

  • Containment Surveyed:

  • Containment:
  • Containment Type:

  • Location of Installation:

  • Containment Manufacturer:

  • Containment Size:

  • Approximate length Installed:

  • Containment Purpose:

  • Method of Support:

  • Photo:
  • Photo:

  • Is Condition Satisfactory:

  • Reason For Unsatisfactory Condition:

  • Photo:
  • Photo:

  • Additional Comments or Observations:

  • Additional Comments or Observations:

  • Existing Record Drawings/Tech Subs Available:

  • Add media

  • Additional Information:

High Level/Ceiling Survey

  • High Level/Ceiling Surveyed:

  • Add Survey:
  • Area Surveyed:

  • Ceiling Type/Material:

  • Ceiling Accessible:

  • Add Photo:
  • Photo:

  • Additional Information:

  • Measurement From Finished Floor Level to Ceiling Underside:

  • Measurement From Ceiling to Slab:

  • Void Areas over 600mm to be aware of:

  • Photo of Area:
  • Add media

  • Additional Information:

  • Additional Comments or Observations:

  • Add Photo:
  • Photo:

  • Additional Comments or Observations:

Low Level/Floor Survey

  • Low Level/Floor Surveyed:

  • Add Survey:
  • Area Surveyed:

  • Floor Type/Material:

  • Floor Accessible:

  • Add Photo:
  • Photo:

  • Additional Information:

  • Measurement From Finished Floor Level to Ceiling Underside:

  • Measurement From Slab to Finished Floor Level:

  • Void Areas over 600mm to be aware of:

  • Photo of Area:
  • Add media

  • Additional Information:

  • Additional Comments or Observations:

  • Add Photo:
  • Photo:

  • Additional Comments or Observations:

Recommendations

  • RECOMMENDATIONS

  • Recommendations

  • Item
  • Recommendations:

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.