Site Survey Cover Sheet
Date: ___________
Product
q Original
q Biaxial
q KeyMark
q Other
I/C
q Yes
60 Series
q Yes
Person conducting the survey: _______________________________________
q No
q No
3, 4, 5, 6, 7 pin (circle)
Job Information
Business/Company Name: ________________________________________________
Person providing tour of facility: ___________________________________________
Building location(s): ______________________________________________________
Possible Expansion
Future Buildings___ qYes qNo
Future Doors ____ qYes qNo
q Double
q Other
Current Key System
Manufacturer(s): ________________
Keyway(s): ____________________
Address and Building #: __________________________________________________
Site Survey
Job Name: _________________________________________ Page ___ of ______
Same As Door #
D oor
No. (If any)
Date: ___________
Location description
H an d
Thickness
Type
L R LR R R
13/8" 13/4" Other ___________
Hollow Metal
Existing Lock
Manufacturer
Model
B ackset
#Cyls.
23/4”
33/4”
Grade 1
Y
Part #
Function
Classroom
K eyed :
C lassroom
Communicating
C ommunicating
Entrance
E ntrance
Passage
Institution
InstitRoom
ution
Store
S tore R oom
Vestibule
Vestibule
Privacy
Finish
(AME) Amerock
(ARO) Arrow
K eyw ay
Tailpiece
N on K
eyed :
Other
__________________
______
P assag e
(BAL) Baldwin
(BES) Best
K eyset
(COR) Corbin
Remarks
(DET) Detex
N
Other
MANUFACTURERS
(ADA) Adams Rite
Wood Aluminum Other ________
M edeco Replacement Cylinder
23/8”
Description of Hardw are
Fire Rating
(DEX) Dexter
Quantity
P rivate
(EMH) Emhart
(FAL) Falcon
D oor
No. (If any)
Same As Door #
Location description
(KWI) Kwikset
H an d
Thickness
Type
L R LR R R
13/8" 13/4" Other ___________
Hollow Metal
Existing Lock
Fire Rating
Wood Aluminum Other ________
(LOC) Lockwood
(LOR) Lori
(MAR) Marks
M edeco Replacement Cylinder
(MED) Medeco
Manufacturer
Model
B ackset
#Cyls.
23/8”
Description of Hardw are
23/4”
33/4”
Grade 1
Y
Institution
InstitRoom
ution
Store
S tore R oom
Vestibule
Vestibule
Privacy
N on K
eyed :
Other
__________________
Other
No. (If any)
Classroom
K eyed :
C lassroom
Communicating
C ommunicating
Entrance
E ntrance
Passage
P assag e
K eyw ay
Tailpiece
K eyset
(SAR) Sargent
Remarks
(SCH) Schlage
(SIM) Simplex
Quantity
(UNI) Unican
(VON) Von Duprin
Same As Door #
Location description
Model
(WEI) Weiser
H an d
Thickness
Type
L R LR R R
13/8" 13/4" Other ___________
Hollow Metal
Fire Rating
Wood Aluminum Other ________
#Cyls.
Part #
Function
Finish
(YAL) Yale
(WES) Weslock
M edeco Replacement Cylinder
B ackset
(PDQ) PDQ
(RUS) Russwin
P rivate
Existing Lock
Manufacturer
Finish
N
______
D oor
Part #
Function
Other ______
K eyw ay
Tailpiece
FINISH
23/8”
Description of Hardw are
23/4”
33/4”
Other
______
Grade 1
Y
K eyed :
Classroom
C lassroom
Communicating
C ommunicating
Entrance
E ntrance
Passage
Institution
InstitRoom
ution
Store
S tore R oom
Vestibule
Vestibule
Privacy
K eyset
N
N on K
eyed :
Other
__________________
P assag e
P rivate
Quantity
Remarks
605
609
606
613
612
625
624
626
Site Survey
2
u
u
Job Name: _________________________________________ Page ___ of ______
u
Date: ___________
1
5
Same as Door # u
8
u
D oor
4
u
No. (If any)
Location description
7
u
6
u
9
u
See Legend
H an d
Thickness
Type
Fire Rating
L R LR R R
13/8" 13/4" Other ___________
Hollow Metal
(ADA) Adams Rite
(AME) Amerock
Wood Aluminum Other ________
(ARO) Arrow
M edeco Replacement Cylinder
B ackset
Model
11
u
MANUFACTURERS
10
u
Existing Lock
Manufacturer
3
12
u
23/8”
33/4”
17
u
Other
4”
Institution
C
lassroom
InstituRoom
tion
Communicating
Store
C
ommunicating Vestibule
S tore R oom
Entrance
16
u Privacy
E
ntrance
Vestibule
Passage
15
u
K eyset
______
P assag e
Quantity
23
u
P rivate
K eyw ay
19
u
20
u
Tailpiece
21
u
Remarks
22
u
N
N
on K__________________
eyed :
Other
Finish
18
u
Classroom
K
eyed :
Grade 1
Y
Part #
Function
14
u
13
u
23/4”
Description of Hardw are
#Cyls.
(BAL) Baldwin
24
u
(BES) Best
(COR) Corbin
(DET) Detex
(DEX) Dexter
(EMH) Emhart
(FAL) Falcon
(KWI) Kwikset
How to complete the Site Survey
1 Fill in the date completely (Month/Day/Year).
u
2 Write in a unique job name or number.
u
3 Write the current page number and the total number of pages when the survey
u
is completed.
4 Write in the door label number in the circle (See door numbering section). If a
u
5
u
door has more than one lock or multiple cylinders, label the box below the circle with A, B, C,
etc. For example, if door 7 has three locks, fill in three separate information boxes and label
them 7A, 7B, and 7C.
To save time when you come across a door that is exactly the same as a
previous door, reference the previous door number here.
Door
6 Write in the door # (if any number is written on the door).
u
7 Write in a description of the door location.
u
8 Check the type of hand.
u
L
“Inside” of door
RR
LR
R
“Outside” of door
9 Check thickness.
u
10 Circle the door type or write in the other type.
u
Existing Lock
14 Enter the number of cylinders—Assumed to be keyed the same unless noted
u
otherwise in the remarks box.
15 Circle yes or no if the lock is Grade 1.
u
16 Circle function of lock or write in the other function.
u
17 Enter any other door hardware (Example: spring hinges, pull, kick plate)
u
Medeco Replacement Cylinder
u Enter part # if known (if unknown, enter “?”)
19 Enter finish (see key)
u
20 Enter keyway.
u
18
21 Enter tailpiece.
u
22 Enter the keyset information during the keying conference.
u
23 Enter the quantity (same as #14).
u
Remarks
u Enter any information to help determine the part # or special needs.
24
u Write in the manufacturer (see legend). If unsure, check the edge of the door
(latch/bolt).
11
12 Write in the model (if known).
u
13 Check backset or write in the other backset.
u
If unknown, indicated with a “?”.
(Example: repair, replace, lever, etc.)
Hardware Site Survey
Page ____ of ____
End-user: ________________
Contact: _________________
Phone no: ________________
D oor # or
Description
Brand/Model
Number
Finish
Date: ________________
Key Section: _________
Registry No: __________
Quantity
of
Cylinders
Cylinder Information
Hand/
B a ckse t
Cylinder Part
Number
Keying
Finish
TLPC/Cam
Quantity
of keys
Special keying instructions or
comments