Information
-
Customer name
-
Contract #
-
Contract type
-
Conducted on
-
Prepared by
-
Location
-
Contact name and info
Job Access Information
-
Contact Person
-
Contact phone number and email if available
-
Specific parking <br>
-
Guard Shack
-
ID Badge required
-
Sign in and out
-
Specific Training
-
Elevator available to move equipment and materials?
-
Other Access Info
Sustainable Safety
-
Does Customer have a Hot Work Permit Process
-
Who is the contact to acquire permit
-
Does customer require additional training for Hot Work?
-
If Hot Work is being performed do you have Trane/IR Hot Work Permit?<br>
-
Is roof access required ?
-
Access location
-
Roof access type
-
Will portable ladder able to be secured with anchor or strap to ensure safe access?
-
Ladder(s) in good condition
-
Roof hatch in good, safe working condition?
-
Is step ladder needed for job
-
How tall does step ladder need to be ?
-
Are there special emergency procedures
-
Are there specific training required ?
-
Adequate lighting in work area?
-
Are hazardous chemicals present in work area
-
Please list HAZ MAT
-
Are MSDS available
-
Will technician have to come in contact with HAZ MAT ?
-
Safe access to VAV Boxes
-
Will rooftop work need to be performed ?
-
Is fall protection needed and is equipment and anchor points available to be used effectively ?
-
Is there a power source available for equipment ?
-
Is there any asbestos identified in work area
-
Take photo of ACM
-
Is asbestos marked and contained ?
-
Does work involve PERMIT required confined space ?
-
Has all training and atmospheric tests been performed with all emergency/rescue procedures in place ?
-
Is fire extinguishers available in area if needed ?
-
Is LOTO Equipment needed and available
-
Is refrigerant monitor in place where refrigerant exposure may exist ?
-
Is working area(s) free from trip and slip hazards ?
-
Emergency procedures in place and trained
-
Additional concerns or information
-
Additional photos
Add more information or photos
-
Additional concerns or information
-
Additional photos
-
Any identifiable upgrades ? (UCP2, New Pumps, Etc.)
-
Are there BAS controls
-
Manufacturer controls
-
Who provides maintenance controls
-
Current water treatment provider
-
Can Trane help bring equipment up to code ?
-
Is cooling contingency on file ?
-
Hot water heating systems
-
Cooling water systems
-
Other equipment information and specifications
-
Signature of auditor