Title Page
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Branch Name
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Branch Number
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Conducted on
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Prepared by
Branch Area
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Is the Roof Internal or external
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If other area selected please specify
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Is Access Required
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What is the form of Access
- Fixed Ladder
- Technician ladders
- Staircase
- Scaffold
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If Yes is there adequate segregation / edge protection / signage
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Is There edge protection fitted to area
- Yes
- No
- N/A
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If yes is it company issues or other
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Is there roof signage fitted
- Yes
- No
- N/A
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Is There access from non Fragile to fragile roof areas
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What is below the the roof area
- Refrigerated Cold rooms
- Butchery Area
- Plant room
- Fish Sales
- Bakery Area
- Offices
- Canteen
- W/C's
- Sales Floor
- Goods in / good out
- Other
