Title Page
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Audit Report Number: (year / office / staff initial / Number per year)
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Survey Report Number:
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Type of Survey audited:
- Management Survey
- Refurbishment Survey
- Management with Refurbishment Elements Survey
- Demolition Survey
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Type of Build
- Domestic
- Commercial
- Industrial
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Client
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Location / site address
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Conducted on
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Auditor
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Surveyor Name:
Survey Details / Requirements:
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Are the details supplied by the office correct, accurate and sufficient for the surveyors needs (state):
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Are there any limitations for the survey (state)
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Since the last audit, has the surveyor had any concerns regarding impartiality?
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If yes, please give details
1.0 Respiratory Protective Equipment:
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1.1 Does the surveyor have the mask that they have been face fit for?<br>(If the answer is no the audit must stop unless they are going to be using a hood)
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1.2 Is the surveyor clean shaven?
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1.3 What mask does the surveyor have:
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Model:
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Size:
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Mask No (red tag)
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State exp date marked on filter:
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Add media
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1.4 Is the mask and storage box clean :
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Notes:
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1.5 Is the RPE checked as outlined in the company procedures for checking RPE (Seals, valves, head straps, filter)
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Notes:
2.0 Personal Protective Equipment:
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2.1 Does the surveyor have coveralls available:
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Type:
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Notes:
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2.2 Does the surveyor have cover shoes available:
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Notes:
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2.3 Do they have the necessary equipment to conduct the survey safely?
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Notes:
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List all RPE worn by the surveyor
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Add media
3.0 Surveyors Tools:
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3.1 Torch:
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3.2 Screwdrivers - flat and crosshead:
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3.3 Knife:
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3.4 Chisle:
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3.5 Bradawl:
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3.6 Fibre Suppressant:
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3.7 Sample Bags:
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3.8 Filler and Paint:
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3.9 Tape:
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3.10 Wet Wipes:
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3.11 Sample labels:
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3.12 Coloured Pens:
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3.13 FB Keys:
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3.14 Square Drive Key:
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3.15 Hammer:
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3.16 Crowbar:
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3,17 Digital camera: and or Tablet:
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H- Type Vacuum
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Drop Sheet
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Other:
4.0 Access Equipment:
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4.1 Does the surveyor have ladders sutable for the survey:
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4.2 Are they company issue:
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Ladder ID number(s)
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Date of next inspection(s)
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Notes:
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4.3 Are they still in a serviceable condition:
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Add media
5.0 Risk Assessment:
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5.1 Has the surveyor completed the site Risk Assessment and is it truly representative of the site:
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Was a Risk Assessment supplied by Management:
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Was a Risk Assessment done on Teams:
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If not was Risk Assessment done on other paperwork:
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Notes:
6.0 Recording of Information:
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6.1 What does the surveyor use to record information and when do they complete it:
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6.2 Plans - Do they show all sample refs and N/A areas:
7.0 Witnessing of Survey by Auditor:
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7.1 Approach to survey: communication with occupants required, system, methodical, throughout:
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7.2 Level and Method of intrusion: are they required to take images of intrusive inspection points and do they:
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7.3 Sampling Activities: describe what they sample and how. Do they sample as they go or leave sampling to the end of the survey:
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7.4 Was the area vacated prior to sampling?
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7.5 Give an example (choose a sample taken) and describe how the sample area and sample was prepared, how it was taken and then stored and how the sample point was made good
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Add media
8.0 Auditors Report: state conclusions any, NCW and / or Obs
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Notes:
9.0 Signature Page
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Signature of Auditor:
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Select date
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Signature of Auditee
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Select date
