Customer Information

  • Customer

  • Venue

  • Address

  • Venue Services customer contact

  • How many spaces does the venue have?

Survey Information

  • Audit conducted by

  • Conducted on

Site Information

  • Is on-site parking available? If NO, then add further local information where possible.

  • Further parking information

  • What are the permitted working hours?

  • Is site-specific PPE required (Hi-viz, goggles, gloves etc.) that is in addition to the standard PPE covered by our generic risk assessments and method statements? If YES then please state what is required.

  • What is required?

  • General description of facilities and spaces

  • Please continue to next section.



  • Name of Space

  • Please state the distance from the floor to the bars/tracks (min/max if necessary)

  • Please state the distance from the bars/tracks to the top fixings (min/max if necessary)

  • Are we permitted to use the customer's access equipment (we are insured to do so)? If YES, then please state what is available.

  • Please indicate customer's access equipment

  • Other access equipment information

  • Please confirm that any access equipment belonging to the customer, has routine inspections where applicable? (MEWP, Tallescope etc)

  • If we are to use our own access equipment in this space, then please state what would be most applicable.

  • Are there any areas that the access equipment will not get us to? If YES, then please provide further information.

  • Further information


  • Number, manufacturer and type of dimmer racks?

  • Is the system hard-wired, patched, or both?

  • Number of HARD-WIRED circuits? (where applicable)

  • Number of PATCH circuits? (where applicable)

  • Number of FACILITY PANELS? (where applicable)

  • What type of connectors are used throughout the installation? (e.g. 15, 16, 63amp; socapex; powercon)

  • Please specify any other circuits to be tested? (tech power, house lights, sound power)

  • Are there any known faults with the electrical installation?

PAT Testing

  • Where will the items be located?

  • Number of PORTABLE DIMMERS? (plug-in type)

  • Number of LANTERNS?

  • Number of LED FIXTURES?

  • Number of MOVING LIGHTS?


  • Number of MULTICORE CABLES and TAILS? (socapex, lectriflex)

  • Number of MAINS ADAPTORS? (4 way blocks, Grelcoes, Jumpers etc.)

  • Number of DESKS and RACK ITEMS? (control desks, cd players, EQ's, amplifiers)

  • Any other items to be PAT tested?

Mechanical Inspection


  • Number of CURTAIN TRACKS?

  • Number of LEG BARS?

  • If any bars are able to be raised and lowered by mechanical means, please state how many and by what means. (e.g. Hemp Sets, Winch Sets)

  • Any other aspects of the mechanical installation to be inspected?


  • Serviceable LIGHTING equipment items.

  • Serviceable AUDIO equipment items.

  • Other serviceable equipment items.

Photos of the space

  • General photos of the space for information

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.