Information
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Document No.
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Project Name
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Client / Site
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Conducted on
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Prepared by
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Location
Site survey
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Contact person and details
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Requested Completion Date
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Requested Installation Date
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System Description
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Site Access and Parking
System Input Sources
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System inputs
- video
- s-video
- component
- VGA PC
- DVI PC
- HDMI PC
- Display Port PC
- VGA Laptop
- HDMI Laptop
- Display Port Laptop
- Display Port Laptop
- Visualiser HDMI
- Visualiser VGA
- Visualiser DVI
- DVD/BluRay HDMI
- DVD/BluRay analogue
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Input Notes
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Display type
- projector/ manual screen
- projector/ electric screen
- projector/ interactive board
- projector/ no screen
- plasma/ LCD/LED
- other
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Throw Distance
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Screen Size
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Projector brightness (lumens)
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Projector mounting location
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Is power available at high level
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Projector Mounting Method
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Fixing method screen
- screws
- anchor fixings
- chemical
- plasterboard fixings
- wooden pattress
- coach bolts
- other
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Display Size
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Display Location
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Display Type
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Display Mounting
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Distance to bottom of image to floor mm
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Access Needed for project or display.
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Is display plugged into client network?
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Port number and device MAC address
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Projection/Display Notes
Audio Requirements
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Speaker type
- Program passive small system
- Program passive large system
- Program powered small system
- Program powered large system
- Distributive 100v/70v
- ceiling mounted
- wall mounted
- voice
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Speaker Type and Quantity
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Speaker cable type (passive)
- .75mm stranded
- 1.5mm stranded
- 2.5mm stranded
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Audio System Notes
Control system
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Control system make<br>
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Panel type
- button panel
- touch panel
- tablet
- wired
- wireless
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Image of panel
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If plugged into client network what port used and MAC address of panel
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Control System Notes
Network
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Network Point Locations
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Network Notes
AC Power
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AC at projector
- Yes
- No
- Not Applicable
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AC at screen
- Yes
- No
- Not Applicable
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AC at display
- Yes
- No
- Not Applicable
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AC at lectern
- Yes
- No
- Not Applicable
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AC Power Notes
Lectern
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Existing Lecturn Design
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Existing Lectern Photos
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Lectern Colour and Finish
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LecternLocation
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Input Plate and Connections
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Umbilical Location
- Lectern Right
- Lectern Left
- Lectern Centre
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Umbilical Length
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Lectern Notes
Room Details
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Room dims
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Ceiling height including any voids
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Ceiling construction
- concrete
- manufactured (plasterboard)
- suspended ceiling
- open wood beam
- metal sheet
- concrete filled metal
- other
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What is construction?
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Ceiling pictures
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Wall construction
- concrete
- block
- brick
- block with plasterboard
- brick with plasterboard
- stud work with plasterboard
- stud work ply lined plasterboard
- mdf
- other
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What is construction?
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Wall pictures
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Asbestos Register Checked
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Notes on asbestos
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Room Pictures
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Sketch Pad 1
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Sketch pad 2
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Sketch pad 3
Special Notes
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Notes