Title Page

  • Conducted on

  • Prepared by

  • Location

Store Info

  • Store Number

  • Store Name

  • Store Address

  • Store phone number

  • Store Contact Name

  • Store Contact Email

  • Store contact phone number

  • How many Floors

  • Is there room in the store to store new equipment for 2 days?

  • Lift available?

  • Does the store have any accessibility solutions already installed (wheelchair ramps, stairlift etc). If yes please detail

  • OCT solution - BOG or HB?

  • How Many Telephone Lines Come Into The Building?

  • How Many Wired PDQ's (Credit Card Machines)?

  • Does the store have CCTV?

  • Corporate WQB Wifi In Store?

  • New / Additional Access Point Required?

  • How Many Fax Machines does the store have?

  • How Many Wireless PDQ's (Credit Card Machines)?

  • Private Wifi In Store?

  • If Yes, Survey Required?

  • Back-up media - how many tapes?

  • What IT issues is the store currently experiencing? (add prior to survey if available)

Survey Info

  • Survey Date

  • Surveyor Name

  • Add location
  • Time On site

  • Time Off site

Devices

  • Device list - Add all surveyed devices

  • Device
  • Device Manufacturer

  • Device Type

  • IP Address

  • MAC Address

  • DHCP

  • Hostname

  • Monitor Make & Model

  • Monitor mounting

  • Video Connection

  • OS Version

  • OS Type

  • Number of devices connected

  • Fundus device

  • Device Model

  • Serial Number

  • Used for

  • Location - Floor

  • Location - Room/Area

  • In Comms cabinet

  • Which Comms cabinet

  • U location

Cabinet

  • How many Comms cabinets in store?

  • Comms Cabinet details

  • Cabinet
  • Cabinet(s) Location

  • How many Comms Cabinets are in the room?

  • 1st Cabinet Wall or Floor mounted?

  • Cabinet Front

  • At what height is the cabinet from the floor?

  • Are ladders required to access the cabinet?

  • Is the cabinet in good condition?

  • Can it be worked on and opened?

  • How many available and usable space is there for additional network equipment in U ?

  • Is there room in the base of the cabinet for a new Fujitsu TX1330 Server? w177 x d560 x h455 mm

  • How many free power sockets are there on the UPS PDU?

  • How many free power ports are there on the UPS?

  • What Size is the Cabinet? EG 9U

  • Is the room with the cabinet well ventilated?

  • Is there working air conditioning in the room?

  • Are there any signs / indications of overheating (such as smell)?

  • Are any cables / connectors damaged?

  • Number of power sockets at cabinet

  • 2nd Cabinet Wall or Floor mounted?

  • Cabinet Front

  • At what height is the cabinet from the floor?

  • Are ladders required to access the cabinet?

  • Is the cabinet in good condition?

  • Can it be worked on and opened?

  • How many available and usable space is there for additional network equipment in U ?

  • Is there room in the base of the cabinet for a new Fujitsu TX1330 Server? w177 x d560 x h455 mm

  • How many free power sockets are there on the UPS PDU?

  • How many free power ports are there on the UPS?

  • What Size is the Cabinet? EG 9U

  • Is the room with the cabinet well ventilated?

  • Is there working air conditioning in the room?

  • Are there any signs / indications of overheating (such as smell)?

  • Are any cables / connectors damaged?

  • Number of power sockets at cabinet

  • Are ladders required to access the cabinet?

  • Is the cabinet in good condition?

  • Can it be worked on and opened?

  • How many available and usable space is there for additional network equipment in U ?

  • Is there room in the base of the cabinet for a new Fujitsu TX1330 Server? w177 x d560 x h455 mm

  • How many free power sockets are there on the UPS PDU?

  • How many free power ports are there on the UPS?

  • What Size is the Cabinet? EG 9U

  • Is the room with the cabinet well ventilated?

  • Is there working air conditioning in the room?

  • Are there any signs / indications of overheating (such as smell)?

  • Are any cables / connectors damaged?

  • Number of power sockets at cabinet

  • Type of sockets at cabinet

  • Number of sockets in use

  • Has the cabinet been recently installed?

  • Patch cable standard

Wi-Fi

  • Wi-Fi Tests

  • Location
  • Location/Room

  • Signal Strength

  • Speed Test

Wide Area Network (WAN)

  • Location of Network Termination Point

  • Picture of NTE/NTP points

  • Mark up the location of NTE/NTP or the DP in relation to the main Comms cabinet location

  • Are there 3 power sockets available at NTP?

  • Distribution Point location and markings

  • Picture of DP

  • Anything blocking access to DP?

Power Sockets

  • Power socket count

  • Location
  • Location/Room

  • Number of Sockets

  • Sockets in use

  • Daisy Chained?

  • Condition

  • Describe the condition of the socket and whether deemed unsafe

Switch Capacity

  • Port Tests

  • Switch
  • Switch make and model

  • Ports

  • Port
  • Patched?

  • Used?

  • Corporate or Fundus

  • Network?

Structured Cabling

  • Cabling Tests

  • Patch panel
  • Ports

  • Port
  • Wall port ID (1,2,3 or 101,102,103 etc)

  • Are patch panel and wall socket labels the same?

  • Data outlet location

  • Test Results

  • Type of Cabling

IT MOT Report

  • Wi-Fi Status

  • Recommended Action

  • Items (list all required kit)

  • Cost

  • WAN upgrade

  • Recommended Action

  • Items (list all required kit)

  • Cost

  • Desktop Client Upgrade RHEL 6.5 Gold Build

  • Recommended Action

  • Items (list all required kit)

  • Cost

  • iPad/iOS

  • Recommended Action

  • Items (list all required kit)

  • Cost

  • Comms Cabinet

  • Recommended Action

  • Items (list all required kit)

  • Cost

  • Ports and Power

  • Recommended Action

  • Items (list all required kit)

  • Cost

  • Cabling

  • Recommended Action

  • Items (list all required kit)

  • Cost

Summary and Sign off

  • Did Power and Structured Cabling tests Pass overall

  • Cab layout recommendations and a Quick summary of major issues

  • Name and signature of inspector

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.