TWC Self Survey Document

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					Toilet and washroom website estimate self-survey document                        Qty                Qty                                   Qty               Qty              Qty             Qty              Qty              Qty             Qty             Qty             Qty           Please state
Company details (customer)
                                                                     Poor       Fair       Good

Accessibilty site
Ancilleries (insert material composites in comments section)       T/r/disp             Soap disp         A/fresh                               P/towel           R/towel          Wad             San/disp         Con/disp         San/bin         W/bin                           Other
Bath material                                                      no.                  Chrome            Plastic                               Porcelain         Steel                            Ceramic                                                                           Other
Bidets                                                             no.                  Chrome            Plastic                               Porcelain         Steel                            Ceramic                                                                           Other
Ceiling                                                            m2                                     Plastic            Melamine                             Steel            S/steel                          Wood             Tile            Painted                         Other
Channel                                                            no.                  Chrome            Plastic                               Porcelain                          S/steel         Ceramic                                                                           Other
Cubicles (wc material)                                             no.                                                       Melamine           Porcelain         Steel            S/steel                                                                                           Other
Cubicles (toilets)                                                 no.                  Toilets           Seats                                 Lids              doors                                                                                              Curtain         Other
Cubicle (toilet lid material)                                      no.                                    Plastic                                                 Steel            S/steel                          Wood                                                             Other
Cubicle doors                                                      no.                                    Plastic            Melamine                             Steel            S/steel                          Wood                                                             Other
Cubicle walls                                                      m2                                     Plastic            Melamine                             Steel                            Ceramic                           Tile            Painted                         Other
Doors                                                              no.                                    Plastic            Melamine                             Steel            S/steel                          Wood                                             Curtain         Other
Floors area                                                        m2                                     Plastic            Melamine           Lino              Carpet           Vinyl           Ceramic          Wood             Tile            Painted                         Other
Floors drains                                                      no.                                                                                                                                                                                                               Other
Lighting (facility)                                                                                                                                                                                                                                                                  Other
Light fixtures                                                     no.                  Chrome            Plastic                                                 Steel            S/steel                                                                                           Other
Light switches                                                     no.                  Chrome            Plastic                                                 Steel            S/steel                                                                                           Other
Mirrors                                                            no.                  m2                                                                                                                                                                                           Other
Pipework                                                           m2                   Chrome            Plastic                               Copper            Steel            S/steel                                                                                           Other
Power supply (access)                                                                                                                                                                                                                                                                Other
Radiators                                                          no.                  Chrome                                                  Copper            Steel            S/steel                                                           Painted                         Other
Showers cubilcles (material)                                       no.                                    Plastic            Melamine                             Steel            S/steel                          Wood             Tile            Painted                         Other
Showers doors                                                      no.                                    Plastic            Melamine                             Steel            S/steel                          Wood                             Painted         Curtain         Other
Shower walls                                                       m2                                     Plastic            Melamine                             Steel            S/steel                          Wood             Tile            Painted                         Other
Sinks                                                              no.                                    Plastic                               Porcelain         Steel            S/steel                                                                                           Other
Vanity unit                                                        no.                  Chrome            Plastic            Melamine           Porcelain         Steel            S/steel                          Wood             Tile            Painted                         Other
Vents                                                              no.                  Chrome            Plastic                                                 Steel            S/steel                          Wood                             Painted                         Other
Urinals                                                            no.                                    Plastic                               Porcelain         Steel            S/steel                                                                                           Other
Wall area                                                          m2                                     Plastic            Melamine                             Steel            S/steel         Ceramic          Wood             Tile            Painted                         Other
Washroom condition (décor appearance)
Washroom condition (odour control)
Water supply (access)                                                                                                                                                                                                                                                                Other
Wc floor level                                                                                                                                                                                                                                                                       Other
Windows                                                            no.                  m2                plastic                                                 Steel            S/steel                          Wood                             Painted                         Other

Type of clean:
Professional                                                                  T/r/disp=toilet roll dispenser-Soap disp=soap dispenser-A/fresh=air freshner unit-P/towel=paper towel dispenser-R/towel=Roller towel cabinet
Clinical                                                                      Wad=warm air drier-San/disp=sanitary dispenser unit-Con/disp=condom vending machine-San/bin=sanitary disposal bin-W/bin=waste bin
Comments




Completed to the best of my knowledge and accepted that any quotation received based on the information provided may be subject to amendments upon site survey or job commencement/variances
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posted:2/27/2012
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