Title Page

  • Document No.

  • University of Surrey - 5GIC Infrastructure Construction Project

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Health and Safety

Signing and Guarding of Works

  • Has the work area, includkng the storage of plant materials been signed and guarded adequately

  • If No, add information

  • Picture before corrective measures

  • Picture after corrective measures

Working at Height

  • Are all works conducted at below 2 metres above ground and don not require access to roof tops?

  • If No, add Information

  • Picture

Asbestos Risk and other Hazardous Chemicals

  • Is there any indication that either asbestos or other hazardous chemical or material are present in the proximity of the work area?

  • If Yes, add information

  • Picture

PPE Requirements

  • Have all operatives complied with th site rules and using PPE required for the works undertaken?

  • If No, add information

  • Picture

Site Access, Egress and Lone Working

  • Are the works located in the areas where access is restricted due to client requirements or within areas where "confined spaces" procedures need to be applied?

  • Describe process undertaken

  • Are operatives working alone?

  • Describe process undertaken

Manual Handling

  • Does the work necessitate the lifting or moving of heavy objects or use of vibrating plant?

  • If Yes, describe measures being taken

Construction Phase

Power Supply Installation and Testing (inc. Containment and Cabinets)

  • Are all power supply installation works completed to the required specificstion and tested?

  • If No, why?

  • Picture

  • What is the estimated completion date for the power supply installation works?

Hand Over of Completed Site

  • Have all of the works related to the picocell in question been completed to the satisfaction of the contract administrator and a handover inspection/meeting been conducted?

  • Picture

  • Information

Electronic Signature of Auditor

  • Signature

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