Synergy Site Survey Form

Please complete the site survey form below prior to your installation date
* Must be completed.

Full Name *

Business Name *

Business Address *

Postcode *

Phone

What grill do you require *

Do you need any accessories? *

Accessories

Would you require a stand? *

If no, what are you placing the grill on?

Do you require Natural Gas, LPG? *

Do you have an old grill that needs to be removed? *

Location of existing unit (e.g. main kitchen, 3rd floor pantry etc):

Same location for new install? If not, new install location:

Existing item make:

Existing item model:

Existing item dimensions in mm (WxDxH) :

Is existing unit part of a suite?

Is existing item gas (LPG or NG) or electric?

Is the gas supply size available at location of install correct? (i.e. ¾” iron)?

Is the gas supply bayonet within 1.5M of installation point?

Is electrical 13 amp supply available within 1.5 metres of grill install location?

Is new installation point completely under canopy?

Does installation have sufficient permanent Make Up Air?

Is Installation interlocked and working (not bypassed)?

Please advise MAX space available for new unit in mm (WxDxH)

Floor of Installation (e.g. 2nd floor):

How many flights of stairs to manoeuvre equipment:

Lift available?

Number of doorways to manoeuvre through:

Number of turns while manoeuvring equipment:

Times to avoid/access restrictions:

Is parking available on site?

If no, details of nearest parking and costs:

Is there any further information you feel would be useful for our engineers to know about the installation?

If yes, please write here

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