Information

  • Document No.

  • Title of works

  • Conducted on

  • Prepared by

  • Contractor

To be completed prior to works being started

Critical area of work

  • Air conditioners

  • There may be works being carried out which would require additional protection of equipment to ensure no damage occurs during the works being carried out. It may also be of use to shut down all non-essential equipment to reduce the heat output whiles the work is being carried out.

  • Description of work tasks to be undertaken

  • Description of plant/equipment on site

  • Building works

  • There may be works being carried out which would require additional protection of equipment to ensure no damage occurs during the works being carried out.

  • Description of work tasks to be undertaken

  • Description of plant/equipment on site

  • Cabling

  • There may be works being carried out which would require additional protection of equipment to ensure no damage occurs during the works being carried out. Cabling could affect telephones/ broadband/ network connection and therefore systems should be put into place to minimise this prior to the work being carried out.

  • Description of work tasks to be undertaken

  • Description of plant/equipment on site

  • Power

  • There may be works being carried out which would require additional protection of equipment to ensure no damage occurs during the works being carried out. Works on power may affect only parts of the system or the whole building therefore systems should be put in place to ensure that any downtime is as minimal as possible.

  • Description of work tasks to be undertaken

  • Description of plant/equipment on site

  • Racks

  • There may be works being carried out which would require additional protection of equipment to ensure no damage occurs during the works being carried out. Any works to racks could also affect cabling & power, therefore a system to be put in place to ensure that there is minimal disruption to systems whilst work is in progress.

  • Description of work tasks to be undertaken

  • Description of plant/equipment on site

Date of work commencing

  • Select date

Approval & evidence

  • Management approval

  • Select date

Areas / systems affected

  • Areas affected

  • Details about affected areas and systems put in place.

  • Will there be any downtime of systems

  • Accepted down time of systems

  • Contractor

  • Manager

Completion of works

  • Completion

  • Details of works undertaken

  • Will any other works be required

  • Description of additional works

  • Expected date of additional works

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.