Title Page

  • Works Commenced On

  • You MUST click the pin icon, do not manually type a location.

  • Store Location
  • Store Number

  • Store Name

  • Conducted By

Store Info

  • Has the Store Signing In Book been signed?

  • Why Not?

  • ! Works should not commence without signing the store register !

  • Photograph of Signing In Book

  • Has all site H&S information been read, and understood?

  • Why Not?

Works Detail

  • Job Completed As Per SOW

  • Please list any issues with lanes assigned that can't be fitted in detail:

  • Please provide

  • Store Handed Back Fit To Trade

  • Please Explain

Photos & Details of Works Completed

  • You must add a new response (Using the + Icon) for each lane/pole completed on site.

  • Works Action #
  • Lane Number:

  • Photo of Installed new Pole:

Sign Off Documentation Images

  • ATL Risk Assessment (Clear Image, Signed)

Engineers Sign Off

  • Engineer

  • You MUST click + and fill out the following section for each additional ATL member to sign.

Store Signature

  • Job Title

  • Name

  • Signed

  • COMPLETION TIME & DATE

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.