ATL SERVICES RETAIL LIMITED - SITE SIGN OFF - LOSS PREVENTION WORKS for GATEKEEPER SYSTEMS LIMITED

• Store No.

• CLIENT

  Tesco

  Asda

  Sainsburys

  Morrisons

  Lidl

• Site / Store Name

• Conducted on

  Date

• Conducted by

• Location
  Address

• ATL Lead Installer - Name

• All Other ATL Installers on Site - Names

Pre Start Compliance

• Have ALL ATL Installers Signed in, Shown CSCS Cards and been site inducted.

  Yes

  No

• Do ALL ATL installers have in date client based training scheme certification

  Yes

  No

• Do the Installation team know what to do in the event if a fire & evacuation procedure

  Yes

  No

• Is the Installation team aware of first aid and use of welfare facilities.<br>

  Yes

  No

• Does each Installer know how to report an accident and who to inform.

  Yes

  No

• Is there any requirement to change Safe System of Work from the Risk Assessment and Method Statement.

  No

  Yes

• RAMS Installation Declaration been signed by Team Leader, Each Team Member and Site Manager - Provide Photo of Sheet

  Media

Site Compliance

• Does each Installer have and a hard hat.<br>

  Compliant

  Non-Compliant

• Does the Installer have a Tesco / ATL branded hi-viz vest.

  Compliant

  Non-Compliant

• Is the correct safety footwear being worn by all Installers

  Compliant

  Non-Compliant

• Does each the Installer have the relevant eye/ear protection and safety gloves as outlined in the Risk Assessment

  Compliant

  Non-Compliant

• Is all PPE in good condition.

  Compliant

  Non-Compliant

• Is there a first aid box present on van and fully stocked.

  Compliant

  Non-Compliant

Equipment & Safety

• Are Barriers in Place and of the Correct Type i.e. ( Chapter 8 Clearpath) - Please provide Photo<br>

  Compliant

  Non-Compliant

• Yes

  No

• Has Disc cutter been inspected and associated tooling been inspected and free of faults / damage with correct guards in place

  Pass

  Fail

• Yes

  No

• Is the disc cutter water reservoir filled and working correctly for dust suppression

  Pass

  Fail

• undefined

• Is there clear access and egress to and from the work area.

  Safe

  At Risk

• Have measures been taken to reduce trip hazards.

  Safe

  At Risk

• Is the general public adequately protect from works i.e. (is clear area from cutting)

  Safe

  At Risk

• Yes

  No

IOW Instruction of Work

• Has the GATEKEEPER IOW been provided and understood

  Yes

  No

• Yes

  No

• Has the GATEKEEPER Cart Control Layout Plan Been Provided

  Yes

  No

• Yes

  No

• Are there any Issues with the Route Highlighted (Blue) for the Signal Cable - NOTE: If Yes Highlight on Plan the Change of Route

  No

  Yes

• Are there any Issues with Completing the Lock (Red) & Unlock (Green) Loop shown on the layout plan - NOTE: If Yes Highlight on Plan the Change of Route

  No

  Yes

QC Record of Works

• Provide Photos of All Cables entering Buildings Internal & External

  Media

• Provide Photos of All Signal Cable Routed Internally

  Media

• Provide Photos of All Signal Cables Cuts Routed Externally

  Media

• Provide Photos of All Lock & Unlock Loop Cuts

  Media

• Provide Photos of All Signal Cable Routes with Completed Sealant Finish

  Media

• Provide Photos of All Lock & Unlock Loops with Completed Sealant Finish

  Media

• Have all works been completed to Agreed Standards

  Good

  Fair

  Poor

Completion Of Works

• Provide Photo of Completed GATEKEEPER IOW

• Provide Confirmation & Photo of System Operational 'Live Mode'

Any other comments or info

• Provide any other Details as Required

Audit Sign Off

• ATL Team Leader

  Sign

• Store / Site Duty Manger

  Sign

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