Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
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Staff member on site
Site info
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Is there onsite parking?
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Opening times
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Are there gates, fixed bollards, line marking, approximate size of area, and fencing.
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Are any permits for work required?
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What is required?
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Is there any stock stored onsite?
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What is stored where (just for a rough idea)?
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Is there anywhere for engineers to keep access equipment or spares onsite?
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Locations
Assets on site
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Auto Doors on site
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Number of auto doors on site
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Locations of auto doors
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Dry Risers on site
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Please advise how many floors does this serve
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Air conditioning (Condensers and Cassette unit)
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List equipment details (including locations)
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Photos of equipment (including data plates, working environment)
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Access issues?
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What is required to gain access?
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Fresh air supply (Air Handling Units)
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Location of unit
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Size of filters
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Access issues?
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What is required to gain access?
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Extraction
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Type of Extraction on site (toilet/kitchen)
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location
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Access issues?
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What is required to gain access?
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Distribution boards. Please take 3 photos of each DB (1 x to show location and space around DB, 1 x to show Circuit list, and 1 x with the cover off to see internal space of DB)
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Number of distribution Boards
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Approximate number of circuits across all boards
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Make and model of boards
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Lightning Protection system present
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Emergency lighting
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Can testing be conducted in hours via keyswitches
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Are the emergency light plans (drawings) on site?
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Access issues?
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What is required to gain access?
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Evacuation Chairs present
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Please advise number of Evacuation chairs on site
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Please advise locations of Evacuation chairs
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Fire alarm
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Make
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Model
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Location
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Addressable
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Date on Batteries
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Connected to Remote Monitoring station
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Number of call points?
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Number of smoke detectors?
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Number of heat detectors?
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Number of optical detectors?
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Access issues?
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What is required to gain access?
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Fire Doors on site
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Number of fire doors on site
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Intumescent strips all in tact
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Fire extinguishers
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Number of CO2
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Number of Foam
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Number of Water
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Number of Dry Powder
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Number of Wet Chemical
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Number of Fire Blankets
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Smoke vents present
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Please advise number of smoke vents present
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Sprinklers installed on site
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is the sprinkler system connected to a landlord?
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are all sprinkler heads clear of obstructions
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Are there sprinkler pumps onsite?
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Gas
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Gas Meter location
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Gas appliances
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Gas Boiler
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Number of boilers
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Make
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Model
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Location
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Photo of appliance
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Gas Catering Equipment
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Number of appliances
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Type of appliances
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Locations
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Photo of appliances
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Hot water supply (electric)
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Number of electric water heaters
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Locations of equipment
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Types of equipment
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Photos of equipment
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Lifts on site
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Number of Goods lifts
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Number of passenger lifts
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Roof Safety Equipment present
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Mansafe (horizontal wire system) present
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Fixed access ladder present
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Eye bolts present
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fixed gantries or walkways present
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Shutters present
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Number of shutters
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number of window shutters
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Are there any other additional assets?
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What, how many and locations?
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CCTV System Present
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Make
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Model
Documentation review
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Asbestos survey on site
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Is asbestos present?
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Were there any actions other than Monitor or manage?
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Please take a photo of the actions page
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Date of last survey
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Survey undertaken by (name of company)
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Fire risk assessment on site
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Date of last assessment
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Assessment undertaken by (name of company)
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Emergency lighting certificate present
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Date of last test
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Please take a photo of the certificate
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Is there evidence of a 3 hour test within the last 12 months
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Were there any failures noted
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is there evidence that any remedial works have been undertaken
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Fire alarm certificate present
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Date of last test
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Were there any remedial works identified as per the certification
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is there evidence that 100% of the system has been tested over the last year
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Please take a photo of the certificate
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Fire extinguishers certificate present
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Date of last inspection
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Any failures/replacements identified
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Please take a photo of the certificate
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Fixed wire test certificate present
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Date of last inspection
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Was 100% of the installation inspected in the last 5 years
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Satisfactory/unsatisfactory
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Number of C1 observations
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Number of C2 observations
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Number of C3 observations
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Number of FI observations
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Please take a photo of the observations page
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Gas certificate present
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Date of last test
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Name of contractor who completed inspection
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Were all appliances Safe to Use
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Was a warning notice issued
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Please take a picture of the warning notice
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Please take a photo of the certificate
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Sprinkler certificate present
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Date of last inspection
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name of contractor who completed inspection
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Please take a photo of the certificate
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Auto Doors certificate present
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Date of last inspection
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name of contractor who completed inspection
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Were any failures mentioned
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Please take a photo of the certificate
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Dry riser certification present
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Date of last inspection
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name of contractor who completed inspection
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Please take a photo of the certificate
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Lightning Protection certificate present
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Date of last inspection
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name of contractor who completed inspection
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please take a photo of the certificate
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Evacuation chair certificate present
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Date of last inspection
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name of contractor who completed inspection
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please take a photo of the certificate
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Fire doors certificate present
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Date of last inspection
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name of contractor who completed inspection
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were any remedial works identified
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please take a photo of the certificate
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Smoke Vents certificate present
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Date of last inspection
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name of contractor who completed inspection
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please take a photo of the certificate
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Lift Insurance certification available
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Date of last inspection
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name of company who undertook insurance inspection
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please take a photo of the certificate
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Roof safety certificate present
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Date of last inspection
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name of contractor who completed inspection
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please take a photo of the certificate
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Shutters certification
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Date of last inspection
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name of contractor who completed inspection
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please take a photo of the certificate
