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
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Select date
Location/Building:
Inspected By:
Zone:
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Zone 1
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Zone 2
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Zone 3
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Zone 4
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Zone 5
Priority:
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Priority 1
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Priority 2
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Priority 3
Streets/Buildings/Fire Lanes/Ranges
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Is the surface are visible and a skid free surface attained the length and width of the designated surface?
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Are intersections clear for vehicle access and visibility?
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Are storm drains clear?
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Are snow piles pushed away from the front of structures, facilities, equipment, or placed so as to not block or hinder government access to buildings and utilities?
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Are Fire Department Connections clear and accessible?
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Have all deficiencies and areas that need attention been reported?
Current Condition:
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Complete
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In-Progress
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Moderate
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Limited
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Complete= Street is clear of snow & ice to 100% of standard In-Progress= Street is currently being worked on active schedule Moderate= Street is clear of snow & ice to 80-95% of standard Limited= Street is clear of snow & ice to 60% of standard
Parking Lots
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Are handicap spaces accessible?
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Is there a clear pass at the entrance way free of allocated snow?
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Is there a clear pass at the exit way free of allocated snow?
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Is snow cleared within a maximum of six inches away from the dumpsters in areas for access by solid waste contractor?
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Have all deficiencies and areas that need attention been reported?
Current Condition:
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Complete
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In-Progress
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Moderate
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Limited
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Complete= Parking lot is clear of snow & ice to 100% of standard In-Progress= Parking lot is currently being worked on active schedule Moderate= Parking lot is clear of snow & ice to 80-95% of accessibility Limited= Parking lot is clear of snow & ice to 60% of accessibility
Comments:
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