Title Page
-
Site conducted
-
Works commenced
-
Works completed
-
Prepared by
-
Please choose category of works:
- General maintenance
- Upgrade to existing facilities or infrastructure
- Emergency repairs
- Health and Safety works
- Testing and certification services
- New capital works
- Construction
- Other
-
Describe:
-
What Trade is completing works
- Plumbing
- Electrical
- Carpentry
- Painting
- Glass repair / window cleaning
- HVAC
- Carpets and flooring
- IT and telecommunications
- Work at heights / rope access
- Security / locksmiths
- Other
-
describe service:
-
Company Name
-
Primary company contact details:
-
Onsite name and contact
-
Will isolation of fire monitoring systems be required?
-
Has the chief warden or Operations coordinator been notified?
-
Before isolation inform wardens and staff, establish a monitoring warden for the duration of isolation: name and contact of isolation warden
-
At completion of works re commission fire monitoring systems and inform relevant occupants that works have been completed
-
Are keys and fog access required?
-
main contact number for holder of keys
-
Sign for confirmation of receipt of keys
-
keys returned?
Description and work information
-
Describe works being carried out
-
What location will these works be performed?
-
will high risk works be carried out? eg work at height, hot-works, confined space, etc
-
Has a risk assessment been completed?
Documentation
-
Add details and images of works, discoveries and outcomes:
-
If unexpected issues or discoveries were found please describe and document
-
Are there items that require follow up or further remedial works?
-
Instructions links or relevant reference material please add here:
-
Are there warranty items or documentation? pleas add here
-
Certifications, licences, access codes etc please detail and add here
-
Quotes, invoices receipts please add here
Sign
-
Signed
-
Notes:
