Site survey application Copy

• Site survey conducted on

  Date
• Location of site survey
  Address

• Engineer name

• Please add a site survey here

Site survey

• Uplift, Install or Resite?

  Select Uplift Install Resite

  • Uplift
  • Install
  • Resite

Machine details

• Make and model of machine

• ID & serial number

• For installs and resites will the machine fit on in the new site?

• Are all services available?

• What are the changes needed to be made and who is going to implement them?

Entering and parking

• Permission to park lorry for duration of install (legally and safely)?

  Yes

  No

  N/A

• Is the site suitable for 3.5/7.5 and 18 tonne vehicles?

  Yes

  No

  N/A

• Security requirements? (detail as applicable)

• Is parking provision adequate for lorry - Detail any size restrictions?

• Is ID required to enter premises?

  Yes

  No

  N/A

• What are the access times for the site?

• Method statement/risk assessment required?

• Any images related to entering and parking please upload here

  Media

Location of the machine

• What is the proposed location?

• Is there lift access?

  Yes

  No

  N/A

• Please describe what heavy machinery is needed? e.g Stair walker, securing brackets?

• Please describe the dimensions of the lift. A - Width, B - Depth and C - Door width. Please describe height if necessary.

• Please describe the dimensions for landings. A - Width, B - Depth and C - Door Width. Please describe height if necessary.

• Please describe the door measurements and the number of doors on site?

• Please draw the room layout (if necessary)

  Drawing

• Please input special instructions (if any)

• Any images related to the location please upload here

  Media

Stairs

• Are stairs to be used?

  Yes

  No

  N/A

• Number of flights and stairs per flight?

• Location - interior or exterior?

• Type of stairs? - Wood, metal, marble etc.

• Width of stairs? - Between rails

• Stair cappings secure?

• Height of staircase?

Entrance

• Width limits?

• Steps involved? Yes/No

• Number of steps?

• Dimensions of facia/alcove?

Electrical

• Yes

  No

  N/A

• How many are accessible? Is the customer aware of this?

• Please specify the type of electrical outlet? e.g 13 amp or switched spur?

• Are all wall sockets accessible?

  Yes

  No

  N/A

• Where is the isolation point located for the electrical supply?

• Any images related to electrics please upload here

  Media

• If you were denied any of these questions please state a name and a contact number for queries

Water supply

• Is the water supply direct from a rising main/approved drinking water storage tank?

• Does the water supply have adequate flow and pressure?

• Is there an existing drink machine in location?

• Is the pipe run feeding the unit satisfactorily?

• 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)

• Customer signature below

• If you have any comments please add them here

• Please sign here...

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• Engineer signature below

• If you have any comments please add them here

• Please sign here...

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