Site Survey Report - Doors

• Survey Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Store details

• What is site address?
  Address

• What is the store number?

  Safe

  At Risk

  N/A

• Who is the GMM / MOM

  Yes

  No

  N/A

• Where is the door located in the store ( confirm with store manager / Genco office)

  Safe

  At Risk

  N/A

Working / customer Restrictions

• Are there time restraints for working?

  Yes

  No

  N/A

• Are there residents above / close by?

  Yes

  No

  N/A

• Do we require a specialist sub contractor?

  Yes

  No

  N/A

RAMS Packs / Permits

• Will it be necessary to log on to Verisae?

  Yes

  No

  N/A

• Will a RAMS pack be required?

  Yes

  No

  N/A

• Will a permit to work be necessary?

  Yes

  No

  N/A

Asbestos Management

• Has an Asbestos Survey been carried out by the client?

  Yes

  No

  N/A

• Is it necessary to check the report?

  Yes

  No

  N/A

• Will an intrusive survey be required?

  Yes

  No

  N/A

Survey to door. Description of Door, type, attachments and surroundings.

• What is the condition of the structure the door frame is fixed to? ( Take Photo)

  Yes

  No

  N/A

• What is the condition of the door frame? ( Take photo)

  Yes

  No

  N/A

• Take photos of door inside and outside with full description

  Yes

  No

  N/A

• What are the size of the doors?

  Yes

  No

  N/A

• What is the overall structural opening

  Safe

  At Risk

  N/A

• What is the door made from.? Size and thickness

  Yes

  No

  N/A

• Is the door a dedicated fire escape? ( Take photo)

  Yes

  No

  N/A

• If yes is there panic escape locking on ?

  Yes

  No

  N/A

• If not a fire door what locks are on the door ( Take photo and full description)

  Yes

  No

  N/A

• Is there additional locking to head and floor? ( Take photo )

  Yes

  No

  N/A

• Are there closures to the door? Are they working properly (Take photo)

  Yes

  No

  N/A

• Are there mag locks to the doors? Are they working properly ( take photo)

  Yes

  No

  N/A

• Is the door fitted to the fire alarm? If yes this will need to be re connected by store.

  Yes

  No

  N/A

• Are there spy holes on the door? (Take photo)

  Yes

  No

  N/A

• Is there any glass? Dims and description

  Yes

  No

  N/A

• What signage is on door?

  Yes

  No

  N/A

• Take photo and description of door threshold

  Yes

  No

  N/A

• Confirm desired colour with store manager ( white or grey will speed up production )

  Yes

  No

  N/A

Sketches and notes, additional information

• Add drawing

  Drawing

Access and Egress

• When can install be carried out. During store working hours or out of hours? Preferred day of the week / weekend

  Yes

  No

  N/A

• Do we need to provide barriers signage for staff, customers, public

  Yes

  No

  N/A

• Is there safe access?

  Yes

  No

  N/A

Towers / scissor lifts / plant

• Is a working platform required?

• What other plant / tools are required

Personal Protective Equipment (PPE)

• Any special PPE required?

  Yes

  No

  N/A

PFS Works

• Is there any forecourt works? Is the door at a Petrol filling station

  Yes

  No

  N/A

Waste Management

• Do we need to take old door to a licensed waste facility?

  Yes

  No

  N/A

Welfare Facilities

• Can we use current welfare on site?

  Yes

  No

  N/A

Next Steps / further info required

Sign off

• Audit concluded at:

  Date

• Surveyor

  Sign

Closure : to be completed by H&S Advisor

• All actions on this report have been completed on:

  Date

• H&S Advisor

  Sign