Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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ATM 1 internal floor to top of ATM dimensions
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Personnel
Survey Details
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Surveyor Name:
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Survey Date:
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Client
General Site Information
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Store Name:
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Store Number:
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Store Manager:
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Store Address:
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Store Telephone Number:
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Store Opening Times:
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Landlord controlled site Yes / No
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Does the store have a night shift Yes / No
Delivery Of Hardware
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Any Delivery Restrictions, Yes or No? If Yes Specify:
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Any Restrictions on Traffic? Yes/No. If Yes Specify:
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Any Noise restrictions, Yes or No? If Yes specify:
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Any Restrictions on Parking, Yes or No? If Yes Specify:
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Location to Off Load:
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Delivery via Scissor Lift, Yes or No? If Yes Note Weight Limit:
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Photos Of Location for Delivery Vehicle To Off Load:
Special Delivery Equipment:
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Specify Special Delivery Equipment Required, i.e. pallet truck, skates etc.
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Add media
Obstacles On Route to SSC Position:
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Kerb, Yes or No? If Yes Specify Height:
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Stairs Yes or No? If Yes Specify Number of Steps and Height:
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Add media
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Mat Well Yes or No? If Yes Specify Size:
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Any Other Obstacles On Route To SSC Position, Yes or No? If Yes Specify:
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Photos Of Any Obstacles on Route To SSC Position:
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Ceiling Height low bulk
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Ceiling Height High Bulk
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Ceiling Tile type & dimensions of tiles
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Add media
Doors On Route To SSC Position
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Minimum Door Size On Route To SSC Position:
Delivery Route External Floors:
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External Floor Types:
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Other:
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Add media
Delivery Route Internal Floors:
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Internal Floor Types:
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Other:
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Measure Floor tiles and take photo with coin on tile
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Add media
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Internal Floor Covering:
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Add media
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SSC route from Vehicle to Installation position step by step
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Add media
Existing SSC on site
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Version of existing SSC V4 or V5 ?
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Add media
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Quantity of existing SSC on site
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Add media
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Is There a Rap Screen on site Yes/No ?
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Add media
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Is there an existing Coupon bin Yes/No ?
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Add media
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Are the Existing SSC services Over Fed or underfed
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Add media
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Do they existing SSC have Catalina Printers Yes/No ?
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Add media
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Are the Existing SSC Secured to the floor Yes/No
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Add media
Internal Detail:
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Store Door 1 dimensions
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Store Door 2 dimensions
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Centre Management Door 1 Dimensions
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Centre Management Door 2 Dimensions
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Security contractor for store and contact details
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Are there any CCTV cameras in the area Yes/No
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Add media
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Is there any Panic alarms on the SSC or coupon bins ?
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Add media
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Is there any additional building works required to allow the SSC to be removed / installed ?
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Add media
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Measure the overall distance for the SSC area and allowing for the 50mm gap between the SSC will the area work
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Add media
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Will floor repairs be required Yes/No ?
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Add media
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Will ceiling repairs be required Yes/No ?
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Add media
Additional requirements
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Any Refrigeration Need Relocating, Yes or No? If Yes Specify
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Add media
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Any Existing Tills Need Relocating or Removing Yes or No? If Yes Specify?
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Add media
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Any Shelving/Gondola Need Relocating, Yes or No? If Yes Specify
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Add media
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Any Other Obstacles Need Relocation? Yes or No, If Yes Specify With Possible Relocation Position.
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Add media
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Any Internal Signage To be Relocated Yes or No? If Yes Specify
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Add media
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Any Window Vinyls required Yes/No ?
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Add media
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Any Internal Services To Be Relocated? Yes or No. If Yes Specify.
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Add media
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Mark up services route on drawing from SSC position to DB area take photo once complete and send through
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Add media
Electrical/Data Detail
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Fuse board Location
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Add media
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Comms Cabinet Location
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Add media
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Location Of DP
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Add media
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BWIC ( Builders Work In Connection )
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BWIC 1
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Add media
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BWIC 2
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Add media
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BWIC 3
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Add media
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Add signature
