Title Page

  • Name of Property

  • Conducted on

  • Location
  • Why has this survey been requested?

    System
  • Area of Building

  • System Identification(LTHW, Extract Vent, Domestic Services etc)

  • Specific and crucial information (pipe size, connection type etc)

  • Add media

  • Describe the condition of the system including any reported operational issues Include images of any faults

  • Recommendations

  • Information on plant/equipment (use image of ID plate where possible) Ensure connection sizes are included.

  • Include images of system and ID Plates/serial numbers of all plant

Sign Off

  • Who Carried out the survey

  • Add signature

  • Select date

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.