AJK Check List - Rev 4

• Client

• Address

• Operative

• Have you fitted barrier to limit entry to premises?<br>Attach media proof if relevent

  Yes

  No

  N/A

Check List

• Is a 2 minute risk assessment required

  Yes

  No

• 2 Minute Risk Assessment

Add assessment
• Location of works
  Address

• Select date

  Date

• Description of works:

• Are there any susbect materials which could be Asbestos Containing Materials and have not been confirmed

  Yes

  No

• Does the asbestos Register/Management plan show any Asbestos containing materials that will be affected by the works you arte carrying out in the area

  Yes

  No

If you answerd YES to either of these questions you must contact the health and safety officer for advise before you carry out any work

• Identify Hazards associated with works undertaken

  Select Loft Access Hot Works Use of ladder Lifting and carrying Underfloor access Drilling use of step ladder Handling waste cellar access Cutting/Grinding Tower scaffold Unsafe structure Access/Egress Dust Roof Works Poor Hygine Confrontation Hazardous Substances Weather Conditions Public Hand Vibration

  • Loft Access
  • Hot Works
  • Use of ladder
  • Lifting and carrying
  • Underfloor access
  • Drilling
  • use of step ladder
  • Handling waste
  • cellar access
  • Cutting/Grinding
  • Tower scaffold
  • Unsafe structure
  • Access/Egress
  • Dust
  • Roof Works
  • Poor Hygine
  • Confrontation
  • Hazardous Substances
  • Weather Conditions
  • Public
  • Hand Vibration

• List additional hazards and explain in more detail

• Controls required reducing risks from hazards identified above

  Select Ear protection Fire Extinguisher Ladder anti-slip Warning signs Eye protection Heat mat Ladder stand off Barrier Tape Safety footwear fire check/permits loft board rigid barrier Safety helemt RCD Harness & Lanyard Two person lifting Hi Vis Clothing Tidy work area Lights Sack barrow Confirm exposure likey to be below 2.5m/s2A(8) EAV (100 Points)

  • Ear protection
  • Fire Extinguisher
  • Ladder anti-slip
  • Warning signs
  • Eye protection
  • Heat mat
  • Ladder stand off
  • Barrier Tape
  • Safety footwear
  • fire check/permits
  • loft board
  • rigid barrier
  • Safety helemt
  • RCD
  • Harness & Lanyard
  • Two person lifting
  • Hi Vis Clothing
  • Tidy work area
  • Lights
  • Sack barrow
  • Confirm exposure likey to be below 2.5m/s2A(8) EAV (100 Points)

• Additional information and controls not listed

• Occupier informed of risks

  Yes

  Void

• Any further advise required

  Yes

  No

• Details of who to telephoned and the action/advise agreed:

Use http://www.hse.gov.uk/vibration/hav/vibrationcalc.htm to confirm virations expose if unsure

• Print Name

• Signed

  Sign

• Date

  Date

• Do you have method statements and risk assessement available on-site

  Yes

  No

• Is an electrical permit to work required

  Yes

  No

• Electrical permit to work

Add Permit

• Job reference number

Electrical Permit to work

• Address

• I certify that the following electrical equipment has been made dead, electrically isolated, earthed if necessary and all other relevent measures have been taken to ensure that the work and/or test specified below can be performed in a safe manner

• WORKS/TESTS to be completed

• Location of isolation

• Location of locks

• Location of keys

Authorisation

• Add signature

  Sign

• Time and date

  Date

• Is the isolation standard available on-site

  Yes

  No

• Type of work carried out

  Void

  Upgrade

  Re-wire

  Heat Solutions Council

  Electrical Testing

• Does the installation require a NICEIC certificate? If so which one?

  Domestic Minor Works

  Domestic electrical installation

  Domestic Condition Report

  Electrical Condition Report

  Council test report

• Quantity of Minor Works cert completed

• are the NICEIC certificate(s) complete

  Yes

  No

• Are all accessories and outlets in good servicable condition?

  Yes

  No

  N/A

• Does bonding meet requirements of BS7671

  Yes

  No

  N/A

• Locations of protective equipotential bondings?

• Evidence of protective equipotential bondings.

  Media

• Have fan and heating fused spurs been fitted with 3 amp fuses?<br>Provide evidence below.

  Yes

  No

  N/A

• Have all circuits been identified and all relevent labels attached?<br>Include media showing this below.

  Yes

  No

  N/A

• Include media of distribution board with cover off.

  Media

• Does the installation require a NICEIC certificate? If so which one?

  Domestic Minor Works

  Domestic electrical installation

  Domestic Condition Report

  Electrical Condition Report

  Council test report

• Is the NICEIC certificate complete?

  Yes

  No

  N/A

• Does bonding meet requirements of BS7671?

  Yes

  No

  N/A

• Locations of protective equipotential bondings?

• Evidence of protective equipotential bondings.

  Media

• Have fan and heating fused spurs been fitted with 3 amp fuses?<br>Provide evidence below.

  Yes

  No

  N/A

• Have all circuits been identified and all relevent labels attached?<br>Include media showing this below.

  Yes

  No

  N/A

• Include media of distribution board with cover off.

  Media

• Do tails enter through a specific gland

  Yes

  No

• Is NICEIC certificate complete?

  Yes

  No

  N/A

• Locations of water bond

• Evidence of water bond.

  Media

• Location of gas bond

  Yes

  No

  N/A

• Evidence of gas bond

  Media

• Have fan and heating fused spurs been fitted with 3 amp fuses?<br>Provide evidence below.

  Yes

  No

  N/A

• Have all circuits been identified and all relevent labels attached?<br>

  Yes

  No

• Add media

  Media

• Include media of distribution board with cover off.

  Media

• Does the installation require a NICEIC certificate? If so which one?

  Domestic Minor Works

  Domestic electrical installation

  Domestic Condition Report

  Electrical Condition Report

  Council test report

• Is NICEIC certificate complete?

  Yes

  No

  N/A

• Locations of protective equipotential bondings?

• Evidence of protective equipotential bondings.

  Media

• Are pipes cross bonded at boiler?<br>Provide evidence below.

  Yes

  No

  N/A

• Is the installation fitted in accordance with manufacturers instructions?

  Yes

  No

  N/A

• Has heating fused spur been fitted with 3 amp fuses?<br>Provide evidence below.

  Yes

  No

  N/A

• Have all circuits been identified and all relevent labels attached?<br>Include media showing this below.

  Yes

  No

  N/A

• Have you plugged in all appliances in the property and re-energised

  Yes

  No

  N/A

• Does the installation require a NICEIC certificate? If so which one?

  Domestic Minor Works

  Domestic electrical installation

  Domestic Condition Report

  Electrical Condition Report

  Council test report

• Is the NICEIC certificate complete?

  Yes

  No

• Does the bonding meet the requirements of BS7671?

  Yes

  No

• Do tails enter through specific gland?

  Yes

  No

  N/A

• Is grommet strip fitted?

  Yes

  No

  N/A

• Location of water bond?

• Evidence of water bond.

  Media

• Location of gas/oil Bond?

• Evidence of gas/oil bond

  Media

• Are the circuits labeled?

  Yes

  No

• Is an RCD warning label attached?

  Yes

  No

  N/A

• Have all connections been tightened to 2.3 Nm

  Yes

  No

  N/A

• Have you attached a label showing inspection dates and recommened re-test date?

  Yes

  No

• Is a duel colour warning label fitted

  Yes

  No

  N/A

• Evidence of completed distribution board with cover removed

  Media

• Evidence of completed distribution board with cover fitted and all relevent stickers attached

  Media

• Have you plugged in all appliances in the property and re-energised

  Yes

  No

  N/A

Extra information

• Is there any follow up works for other trades?

  Yes

  No

  N/A

• Discription

• Is there any damage or custromers concerns?

  Yes

  No

  N/A

• Is the property tenanted

  Yes

  Void

Customer Satisfaction

• Was the appointment time kept

  Yes

  No

  N/A

• Did the operative present ID card

  Yes

  No

  N/A

• Were you advised of potenial hazards in line with HSE during 2 minute risk assessment?

  Yes

  No

  N/A

• Did the operative protect the property with dust sheets and were safety signs in use?

  Yes

  No

  N/A

• Were all operations explained to you?

  Yes

  No

  N/A

• Has the operative left all operating and manufacturers installation instructions?

  Yes

  No

  N/A

• Has the property been left clean and tidy

  Yes

  No

  N/A

• Are all appliances been plugged back in and re-energised

  Yes

  No

  N/A

• Customer Signature

  Sign

Comments

• Add any issues or additional comments

Sign off

• I confirm that the job is complete

• Operatives Signature

  Sign