Title Page

  • Date work carried out

  • Technician name

  • Store

  • Discipline

  • Enter Relevant Job Details:

  • DRA
  • Job Number

  • Location of works

  • Areas Specified

  • Task description

  • Tools and Equipment Required For Task

  • Other Tools or Equipment Required

  • Identified Hazards

  • Other hazards identified. N.B THIS SECTION IS MANDATORY. Here are some typical examples of what may be encountered:- E.g. Asbestos, sub zero conditions, lack of lighting, customers, staff, FLTs, live cables in wall, children in store, planned fire alarm in store, other contractors working on site.

  • Control measures

  • Other control measures identified. N.B THIS SECTION IS MANDATORY. Here are some typical examples of what may be encountered:- E.g. Confirmation area free of Asbestos by checking register, limit work time in sub zero temps, use of cable detection tool, provision of task lighting, barriers and safety signs, awareness of FLT routes, live cables in wall, familiarisation of local fire procedures, communication with other contractors.

2

  • Work Permit

  • Copy of permit

  • Any additional work permits required

  • Managers authorisation signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.