1. RECORD OF ACTIVITY:

• Conducted on

  Date

• Prepared by

  Select Andrew Lewis Mark Whitehead Richard Murrell Huw Lewis Elliot Willmar OTHER:

  • Andrew Lewis
  • Mark Whitehead
  • Richard Murrell
  • Huw Lewis
  • Elliot Willmar
  • OTHER:

• Name:

• Please select activity to be logged:

  Site Visit

  Incursion

  Machine Repair

  Site Activity

  OTHER:

• Please select type of visitor:

  FWM

  Landowner

  Fuel Delivery / Mechanic Visit

Landowner Visit:

• Any comments discussed:

  Yes

  No

• Comments:

• 

• CONSIDER GETTING LANDOWNER TO COMPLETE NOTES AND SIGN TO CONFIRM

  

• Landowner Signature:

  Sign

Fuel / Mechanic Delivery Visit:

• ENSURE THE CORRECT PPE IS ON AT ALL TIMES:
  

  

• 

• DO NOT GO UNDER LEANING TREES

• 

• BE CAREFUL ON UNEVEN GROUND / BRANCHES / DEBRIS

• 

• DO NOT CLIMB ON TIMBER OR TIMBER STACKS

• 

• DO NOT APPROACH MACHINES UNTIL AUTHORISED BY OPERATOR

• 

• DO NOT ENTER RISK ZONES DEFINED BELOW

• 

• 

• 

• 

• 

• Site Visit Risk Assessment is reviewed with Visitor

  Yes

  No
Visitor:

• Name & Signature

  Sign

FWM Visit:

• Any comments discussed:

  Yes

  No

• Comments:

• 

• CONSIDER GETTING LANDOWNER TO COMPLETE NOTES AND SIGN TO CONFIRM

  

• FWM Signature:

  Sign

Record Public Incursion:

• Number of persons:

• Comments (incl discussion with Public):

• Please inform FWM of incident via WhatsApp Group

  
What repairs or works have you done?

• What repair was undertaken?

  Select Pipe replacement Engine repair Mechainical Issue Body Work Mainteneance Service OTHER:

  • Pipe replacement
  • Engine repair
  • Mechainical Issue
  • Body Work
  • Mainteneance
  • Service
  • OTHER:

• Please make a quick note of what you did:

• Please add photo of repair:

  Media

• Was the site cleaned up and all materials disposed of correctly?

  Yes

  No

• 

• Please clean up prior to re-starting

  
Site Activity:

• Please select what activity you have done:

  Select Installed Pollution Control Repaired Pollution Control Created / Cleaned out silt traps Created / Cleaned out Grips Installed Safety Signs or Barriers Cleaned brash off PROW/Trail/Track Cleaned brash out of stream/pond/drain OTHER:

  • Installed Pollution Control
  • Repaired Pollution Control
  • Created / Cleaned out silt traps
  • Created / Cleaned out Grips
  • Installed Safety Signs or Barriers
  • Cleaned brash off PROW/Trail/Track
  • Cleaned brash out of stream/pond/drain
  • OTHER:

• Please note comments:

• Please add image:

  Media

• Please add images of completed works

  Media
Other activity:

• Comments:

• Pictures:

  Media