Scope of Works Template

• Document No.

• undefined

• Client / Site / Project
  Address

• Survey carried out on

  Date

• Prepared by

• Location
  Address

Gents Toilets

• Condition of toilets

  Good

  Fair

  Poor

  N/A

• <br>Any Works to be carried out ?

  Yes

  No

  N/A

• Good

  Fair

  Poor

  N/A

• Good

  Fair

  Poor

  N/A

• Condition of plumbing fixtures & fittings

  Good

  Fair

  Poor

  N/A

• Condition of flooring

  Good

  Fair

  Poor

  N/A

• Lighting

  Good

  Fair

  Poor

  N/A

• Condition of showers

  Good

  Fair

  Poor

  N/A

• Condition of locker rooms

  Good

  Fair

  Poor

  N/A

• Is there a disabled toilet Facility

  Yes

  No

  N/A

Ladies Toilets

• Condition of toilets

  Good

  Fair

  Poor

  N/A

• Condition of plumbing fixtures & fittings

  Good

  Fair

  Poor

  N/A

• Condition of flooring

  Good

  Fair

  Poor

  N/A

• Condition of showers

  Good

  Fair

  Poor

  N/A

• Condition of locker rooms

  Good

  Fair

  Poor

  N/A

• Lighting

  Good

  Fair

  Poor

  N/A

Office Areas

• General condition

  Good

  Fair

  Poor

  N/A

• Flooring condition

  Good

  Fair

  Poor

  N/A

• Ceilings

  Good

  Fair

  Poor

  N/A

• Lighting, will this need to be upgraded to LED Fittings

  Yes

  No

  N/A

• General observations & comments

  Good

  Fair

  Poor

  N/A

Reception area

• General observations & comments

  Good

  Fair

  Poor

  N/A

• Flooring condition

  Good

  Fair

  Poor

  N/A

Locker Rooms

• Is there separate male/female Facilites

  Yes

  No

  N/A

Kitchen & Mess Rooms

• General condition

  Good

  Fair

  Poor

  N/A

• Flooring

  Good

  Fair

  Poor

  N/A

• Work tops & cupboards condition

  Good

  Fair

  Poor

  N/A

• Furniture Condition

  Good

  Fair

  Poor

  N/A

External Review

• External condition of building

  Good

  Fair

  Poor

  N/A

• Estimate age of building

  Date

• Is the building a portacabin type structure

  Yes

  No

  N/A

• Condition of ground, trip hazards etc

  Good

  Fair

  Poor

  N/A

• Is the external lighting adequate

  Yes

  No

  N/A

• External services condition

  Safe

  At Risk

  N/A

• Has there been a drainage survey carried out

  Safe

  At Risk

  N/A

Access - Automated Vehicle Gates

• Condition of vehicle gates

  Good

  Fair

  Poor

  N/A

• Is there an automated pedestrian gate

  Yes

  No

  N/A

• Is there a safe walking route

  Yes

  No

  N/A

CCTV

• Has the location got an existing CCTV system

  Yes

  No

  N/A

• Will the system require replacement?

  Yes

  No

  N/A

• Is this a critical location

  Yes

  No

M&E Assets Condition

• Air conditioning units

  Good

  Fair

  Poor

  N/A

• Fire Alarm System Condition

  Good

  Fair

  Poor

  N/A

• Emergency Lighting

  Good

  Fair

  Poor

  N/A

• Lighting

  Good

  Fair

  Poor

  N/A

• Electrical intake room

  Good

  Fair

  Poor

  N/A

• Circuit charts in position

  Yes

  No

  N/A

• Fire alarm zone chart in position

  Yes

  No

  N/A

Water Quality ( L8)

• Has a risk assessment been carried out

  Yes

  No

  N/A

• Does this location have CWS storage tanks

  Yes

  No

  N/A