Title Page
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COF Reference
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Site survey conducted on
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Location of site survey
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Engineer name
Uplift, Install and Resite
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Please add a site survey here
Site survey
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Uplift, Install or Resite?
- Uplift
- Install
- Resite
Machine details
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Make and model of machine
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ID & serial number
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For installs and resites will the machine fit on in the new site?
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Are all services available?
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What are the changes to be made? And who is going to implement them?
Entering and parking
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Permission to park lorry for duration of install (legally and safely)?
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Is the site suitable for 3.5/7.5 and 18 tonne vehicles?
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Security requirements? (detail as applicable)
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Is parking provision adequate for lorry - Detail any size restrictions?
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Size restrictions?
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Is ID required to enter premises?
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What are the access times for the site?
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Method statement/risk assessment required?
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Any images related to entering and parking please upload here
Location of the machine
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What is the proposed location?
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Is there lift access?
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Please describe what heavy machinery is needed? e.g Stair walker, securing brackets?
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Please describe the door measurements and the number of doors on site?
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Please draw the room layout (if necessary)
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Please input special instructions (if any)
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Any images related to the location please upload here
Stairs
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Are stairs to be used?
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Number of flights and stairs per flight?
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Location?
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Type of stairs? - Wood, metal, marble etc.
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Width of stairs? - Between rails
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Stair cappings secure?
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Height of staircase?
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Please describe the dimensions of the lift. A - Width, B - Depth and C - Door width. Please describe height if necessary.
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A?
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B?
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C?
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Please describe the dimensions for landings. A - Width, B - Depth and C - Door Width. Please describe height if necessary.
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A?
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B?
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C?
Entrance
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Width limits?
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Steps involved? Yes/No
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Number of steps?
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Dimensions of facia/alcove?
Electrical
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Please specify the type of electrical outlet? e.g 13 amp or switched spur?
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Are all wall sockets accessible?
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How many are accessible? Is the customer aware of this?
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Where is the isolation point located for the electrical supply?
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Any images related to electrics please upload here
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If you were denied any of these questions please state a name and a contact number for queries
Water supply
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Is the water supply direct from a rising main/approved drinking water storage tank?
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Is there an existing drink machine in location?
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Is the pipe run feeding the unit satisfactorily?
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Is a stopcock with 15MM pipe outlet available - Within 1 meter of the proposed location?
Please complete a new site survey for each machine (unless banked)
Save and submit
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Customer signature below
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If you have any comments please add them here
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Please sign here...
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Engineer signature below
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If you have any comments please add them here
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Please sign here...