Title Page
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Site Name
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Conducted on
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Location
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Northing
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Easting
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Prepared by
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Site survey attendance (name, company)
Existing
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Existing kiosk material
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Current kiosk design (simple sketch)
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Indicative Dimentions
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Existing Lenght (MM)
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Existing Width (MM)
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Existing Height (MM)
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Acoustic
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Explosion relief
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Equipment to remove
- Vents
- Logger
- Solar panel
- Lights
- PMAC
- Items being stored
- Comms box
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General kiosk area
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Kiosk condition
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Equipment to remove
Proposed
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Indicative Dimentions
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Work Required
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New length (MM)
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New Width (MM)
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New height (MM)
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New design (simple Sketch)
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Acoustic
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Explosion relief
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Is civil works required?
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Approximate new concrete surface area?
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New kiosk finish type
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New kiosk colour
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Building to Colour/design match if applicable
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Additional information
Site Hazards and Access
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This report records all known hazards on site. This is not an exhaustive list and the Principle contractor should complete there own Risk assessments.
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Site location and access
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Local area information
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Pressure range
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Hazards on site
- Noise levels >80db possible
- Electricity Sub Station
- Pedestrian subway
- School/nursing home
- Ambulance station, etc.
- Lifting operations/hoists
- Interface with temporary works
- Traffic sensitive road /speed restrictions
- Deep water, sewers channels, river etc.
- lane rental required
- Close proximity of walls and fences
- Restricted access for LGV movement required
- Works require changes to site signage
- Street furniture
- Road closure required
- Above ground hazards e.g. Overhead lines
- Underground hazards e.g. Fibre optic, pipelines, underground structures
- Network rail/ metro/ tramway
- Engineering/structural difficulties
- Bus lanes/red routes, bus stops or one way traffic systems in place
- Area of known vandalism, possible security issue
- Parked cars impacted
- Asbestos present on site
- Work will require "out of hours" site checks
- Slips, trips and falls
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Environmental considerations
- Wildlife and woodland habitat
- Tree preservation order applicable
- Area of outstanding natural beauty
- Noise restrictions
- Site of scientific interest
- Conservation areas
- Listed buildings
- Management of excavation water
- Does NG environmental impact assessment apply
- Is temporary land acquisition required, for lay down area, storage and welfare facility
- Housekeeping issues
- Trees/hedgerows - maintain 0.5m with plant
- Planning authority consents
- Footpath, bridle ways, right of way affected
- Access and egress
- Additional guarding (Heras/Cronus control)
- Waste disposal (Licences/segregation)
- Risk to water course -EA consent
- Risk to wildlife habitat -EA consent
- Adjacent land use
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Comments
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Local area
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Images of hazards
IGRP notes
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Image of site survey form
