Title Page
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System Generated Number
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Cobra SR Number
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Cobra W/O Number
Access Attempts
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Access acquired?
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Provide Information:
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Access Attempts - Dates & Times
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Add signature
Risk Assessment
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Any hazard(s) Identified
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What hazard(s) have been identified?
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Risk Guidance Assessment Number
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Task Specific Risk Assessment - Likelihood
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Task Specific Risk Assessment - Severity
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Risk - Likelihood x Severity
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Control Measures
- Score = 1 -3 Proceed with works
- Score = 4 - 6 List control measures in place
- Score - 7 - 9 Refer to line manager for further advice.
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Control Measures Required
Works Carried Out
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Signed into building?
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Why could you not sign in?
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Description of works required?
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Barrack Damage
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Brief description of the damage.
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Picture of damage
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Asset Number if available?
Works Status
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Works Completed
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- No fault found
- Over the Cap Cost
- Condition restored only
- Fair wear & tear
- Could not replace like for like
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Works not completed?
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- Waiting for Materials
- No Access
- Could not replace like for like
Stock & Materials
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Part No / PO No.
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Part Description
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Qty Used
Asset Condition
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Condition type:
- New
- Acceptable
- Poor
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After picture
Signature ( Works Completion Only)
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Operatives Name
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Time spent on Job? (Hr / Min)
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Date & Time
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Signature
Snr Engineer Signature
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Name
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Select date
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Add signature
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Note : Before commencing any additional work, contact Supervisor for authority to proceed and enter details on blank worksheet.