CE001

• Contract

• Date of Inspection

  Date

• Client

• Requested By

• Site Requisition Number

• Company Representative

  Sign
• Location
  Address

• Client has been provided with the Terms and Conditions prior to site visit - Company Representative

  Sign

• Client has read the Terms and Conditions - Client / Client Representative

  Sign

DISCLAIMER

• The assessors believe the information contained within this assessment to be correct at the time of printing. The assessors do not accept responsibility for any consequences arising from the use of the information herein. The report is based on matters which were observed or came to the attention of the assessors during the day of the assessment and should not be relied upon as an exhaustive record of all possible risks or hazards that may exist or potential improvements that can be made. UNDERGROUND SERVICES - "Temporary structures will normally be secured using metal stakes. It is the responsibility of the Customer to notify the Company in writing of the location of any Underground Services. If the Customer does not own the site they should first check where the Underground Services are with the site owner. The Company may attempt to check for Underground Services by using a CAT scanner, however, CAT scans are not guaranteed to locate all services. The Customer must accept all responsibility, and indemnify the Company against, all damages to Underground Services and any consequential damages and losses." - This statement is within Countryside Events Terms and Conditions. Before a contract can be agreed the Client must read this statement.

  Date

• The Above Disclaimer Has Been Read By The Client

  Yes

  No

  N/A

• Client / Client Representative

  Sign

• Company Representative

  Sign

ACCESS AND EGRESS

• Clear route provided for loading and unloading

  Yes

  No

  N/A

• Route agreed with client

  Yes

  No

  N/A

• Parking agreed with client for Countryside Events vehicles

  Yes

  No

  N/A

SITE CONDITIONS

• Rain

  Yes

  No

  N/A

• Wind

  Safe

  At Risk

  N/A

• Hard Standing

  Good

  Fair

  Poor

  N/A

• Soft Standing

  Good

  Fair

  Poor

  N/A

• Trees Over Hanging

  Safe

  At Risk

  N/A

• Drainage

  Good

  Fair

  Poor

  N/A

• Overhead Lines

  Safe

  At Risk

  N/A

WELFARE PROVISIONS

• Hot Water

  Yes

  No

  N/A

• Toilets

  Yes

  No

  N/A

• Hand Washing Facilities

  Yes

  No

  N/A

TENT LOCATION

• Photo of agreed location

  Media

• Any other requests/notes/comments

UNDERGROUND SERVICES

Location of any underground services as made aware of by the client

• ELECTRICAL

  Yes

  No

  N/A

• WATER

  Yes

  No

  N/A

• GAS

  Yes

  No

  N/A

• PHONE /BROADBAND

  Yes

  No

  N/A

• OIL PIPELINES

  Yes

  No

  N/A

• SErvices drawing provided by client

  Yes

  No

  N/A

• CAT scanning required

  Yes

  No

  N/A

• DRAINS / DRAINAGE

  Yes

  No

  N/A

• OTHER

• Client Signature

  Sign

CONCLUDING DETAILS

• I feel the Client has provided site information to the best of their knowledge - Company Representative

  Sign

• The Details I Have provided for the Above Assessment Are Correct At The Time Conducted - Client / Client Representative

  Sign

• Completion of Assessment - Company Representative

  Sign