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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Personnel
Initial Inspection
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Purchase Order Number
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Initial Inspection of Door prior to full assessment being undertaken.
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Detail why you came to this assessment.
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Photo of the door to be added.
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Door Type
- N/A
- Mirage
- B&D
- Austral/Monsoon
- Airport
- Trevor
- Kone
- Thompson
- Monarch
- Pinnacle
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Model
- N/A
- 4/100
- 6/100
- 8/100
- 10/100
- 8/100 Windlocked
- 10/100 Windlocked
- 8/50
- 10/50
- 8/75
- 10/75 Windlocked
- 10/130
- 10/130 Windlocked
- 8/115
- 10/115
- Series 1
- Series 2
- Series 3
- Panorama
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Bracket L/Hand Side
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Bracket R/Hand Side
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Fixings
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Fixings Checked
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Axle
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Spring Tension
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Right Hand Bearing
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Right Hand Bush
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Left Hand Bearing
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Left Hand Bush
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Slat Condition
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Slat Alignment
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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End Clips
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Connecting Slats
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Wrap on Drum
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Bottom Rail
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Guide Fixings
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Guide Channel Clearance
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Guide Lead-in
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Add any photos to support your assessment.
Chain Operated
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Hand Chain
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Chain Wheel
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Planetary Gears
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Direct Drive
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Chain Guide
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Chain Cleat
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Add any photos to support your assessment.
Motorised
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Motor Bracket
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Bolts/Nuts
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Drive Chain
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Sprocket Alignment
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Sprocket Grub Screw/Keyway
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Emergency Chain Wheel
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Emergency Chain Operates
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Emergency Chain Guide
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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PE Cell
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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PE Reflector
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Floor Loop
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Swipe Card/Key Pad/Remote
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Limits
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Control Box
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Isolator
- N/A
- Checked - OK
- Adjusted - OK
- Good Condition
- Fair Condition
- Poor Condition
- Requires Repairs
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Add any photos to support your assessment.
Final Overall Assessment of Door.
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What is the overall door condition?
Sign-off
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Select date
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Comments
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Client Sigiture
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Technician Signiture
