Site Survey Form

• Document No.

• Audit Company

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

Preliminary Details

• Number of Car Parks on site ?

• Does the Building have any heritage concerns ?

  Yes

  No

  N/A

• What is the current and previous use of the Building ?

• Is there an existing location for a garbage storage area ?

  Yes

  No

  N/A

Council Details

• City of ?

Ceiling

• What type of ceiling is present ?

  Select Flush Ceiling Ceiling Tiles Open Ceiling Timber Ceiling

  • Flush Ceiling
  • Ceiling Tiles
  • Open Ceiling
  • Timber Ceiling

• Other ?

• Height from floor to ceiling ?

Power

• What Power is supplied to the switchboard ?

  Single Phase

  3 Phase

• Select amps ?

  63 amps

  80 amps

  100 amps

• Switchboard Size ?

  12 pole

  24 pole

  36 pole

  48 pole

  60 pole

• Does the Switchboard appear to be Compliant to the latest regulations ?

  Yes

  No

  N/A

• Is there more than one switchboard for this building ?

  Yes

  No

• How many ?

• Please specify details ?

• Is 10 pair Telephone lines present ?

  Yes

  No

  N/A

Lighting

• Is there existing store lighting ?

  Yes

  No

• Is this lighting going to remain ?

  Yes

  No

• What type of lighting exists ?

  Select Halogen High Bays Induction High Bays LED High Bays Fluorescent Tubes Metal Halide LED Tubes Halogen Downlights LED Downlights

  • Halogen High Bays
  • Induction High Bays
  • LED High Bays
  • Fluorescent Tubes
  • Metal Halide
  • LED Tubes
  • Halogen Downlights
  • LED Downlights

• Lighting Wattage if known ?

• Number of Light Fittings ?

• Are there any external lights ?

  Yes

  No

• How many ?

Air Conditioning

• Is there Air Conditioning within this building ?

  Yes

  No

• Is it within the offices only ?

  Yes

  No

• How many Split Systems, Droppers or Cassettes ?

• What type of Air Conditioning is installed ?

  Refrigerated Split System

  Refrigerated Cassette System

  Evaporative Cooling with Cassettes

  Evaporative Cooling with Droppers

• KW size if known ?

• Are there any ceiling fans installed ?

  Yes

  No

• How many ?

Floor

• What type of floor is within the Building ?

  Select Raw Concrete Polished Concrete Clear Epoxy Concrete Painted Concrete Timber Vinyl Carpeted

  • Raw Concrete
  • Polished Concrete
  • Clear Epoxy Concrete
  • Painted Concrete
  • Timber
  • Vinyl
  • Carpeted

• Is the flooring in good Condition ?

  Yes

  No

  N/A

• Is the floor level ?

  Yes

  No

  N/A

• Are there any steps ?

  Yes

  No

• How many are located ?

• Do the stairs have Hand Rails ?

  Yes

  No

  N/A

• Do these Hand Rails comply with the current regulations ?

  Yes

  No

  N/A

• Are there any ramps ?

  Yes

  No

• How many ramps are located ?

• Do the Ramps have Hand Rails ?

  Yes

  No

• Do these Hand Rails comply with the current regulations ?

  Yes

  No

  N/A

• Is there a threshold at the front entrance door ?

  Yes

  No

• Are there any trip hazards ?

  Yes

  No

  N/A

Plumbing

• Are there any toilets within this building ?

  Yes

  No

• What toilets are present ?

  Select Male Female Disabled Unisex Shower

  • Male
  • Female
  • Disabled
  • Unisex
  • Shower

• Is the Disabled toilet compliant with Hand Basin, Grab Rails and Door Opening greater than 850mm ?

  Yes

  No

  N/A

Structure

• What construction are the perimeter walls ?

  Select Concrete Tilt Panel Besser Block Brick Plastered Rendered

  • Concrete Tilt Panel
  • Besser Block
  • Brick
  • Plastered
  • Rendered

• Are there any Structural walls within this building ?

  Yes

  No

  N/A

• Are there any Columns within this building ?

  Yes

  No

• How many ?

• What type of Roof does this building have ?

  Select Flat Pitch Roof Sloping Truss Roof Gable Roof Hip Roof Mansard Roof

  • Flat Pitch Roof
  • Sloping Truss Roof
  • Gable Roof
  • Hip Roof
  • Mansard Roof

• Height from floor to Roof - Internal ?

• What style of Shopfront doors are installed ?

  Select Single Door Double Doors Sliding Doors Automatic Doors Roller Shutter / Door

  • Single Door
  • Double Doors
  • Sliding Doors
  • Automatic Doors
  • Roller Shutter / Door

• What is the door opening width ? Must be greater than 850mm

• Is there a store front awning ?

  Yes

  No

• What style ?

  Bullnose

  Sloping

  Level

• What are the dimensions of the awning ?

• Where is the nearest Fire Hydrant located ? Approx how many metres away ?

Demolition

• Does this site require any Demolition works

  Yes

  No

• Please briefly outline scope here ?

General

• General Observations / General Comments

Photos

• Photos will be required of the following: 1. Store Front 2. Signage Opportunities 3. Walls - Internal and External 4. Floor - Steps, Handrails, Ramps, imperfections, drainage 5. Switchboard and mains supply, IDF/MDF and position 6. External - Carparks, Deliveries, Driveways, Windows, Doors 7. Columns

  Media

• Sketches if required ?

  Drawing

• Add drawing

  Drawing

• Add drawing

  Drawing

Sign off

• Auditors Signature

  Sign