Title Page
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Customer Name
- YOUNG PLANT SALES
- ENVIRO-CLEAN
- HODGE PLANT
- NRS GROUP
- SYNERGY AUTOMOTIVE
- HODGE HEAVY HAULAGE
- CADZOW HEAVY HAULAGE
- CLEARWATER
- GROUND DEVELOPMENTS
- AB2000
- HAMILTON BROS
- MALCOLM CONSTRUCTION
- Hodge Heavy Haulage
- Gordon’s Construction Equipment
- Celmisa Plant Hire
- Magni Telescopic Handlers
- Advance Construction
- McGeady Road Planing
- JMS Plant Hire
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Site Name
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Address
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Prepared by
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Date
SERVICE REPORT
GENERAL INFORMATION
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DATE
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ORDER NO
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MAKE
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MODEL
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SERIAL / REGISTRATION NO
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FLEET / ID NO
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HOURS / MILEAGE
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JOB NO
RISK ASSESSMENT
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PERSONS AFFECTED BY ACTIVITY
- Engineer
- Enviromental
- Site workers
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HAZARDS IDENTIFIED
- Motor Vehicles
- Overhead Services
- Excavations
- Substances hazardous to health (Is COSHH assessment available)
- Working at Height
- Lifting Operations
- Confined Space
- Abrasive Cutting Tools
- Lorry Loaders
- Electric Power Tools
- Fork Lift Trucks
- Excavators
- Welding/Burning Equipment
- Natural Environment
- Overhead Cranes
- Loading Shovels
- Electrical Shock
- Fire Hazard
- Mobile Machinery
- Spillages
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OTHER ITEMS IDENTIFIED
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CORRECTIVE ACTION
- PPE
- Access platform
- Isolation / lockout
- Safety harness
- Exclusion zone
- Lifting equipment
- Body props
- Clean work area
- Spill kits
- Face Mask
- Additional Lighting
- Wait for temperature reduction
- Dust Suppresion
- Fire extinguisher / guard
- Park in safe area
- Designated Work Area
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JOB RISK CATEGORY
JOB DETAILS
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WORK CARRIED OUT
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JOB COMPLETED
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ADDITIONAL COMMENTS
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PHOTOGRAPH
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TRAVEL START
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TIME ON SITE
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TIME OFF SITE
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TRAVEL FINISH
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HOURS ON SITE
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HOURS ON TRAVEL
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TOTAL HOURS
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MILEAGE TO
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MILEAGE FROM
PARTS USED / SUPPLIED
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Part no, Quantity, description
COMPLETION
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ACCEPTANCE OF WORK
I certify that the above work was carried out satisfactorily and that the spares as detailed above were used or delivered. -
Customer Name and Signature
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Position
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ENGINEER
I have conducted the risk assessment as shown and completed the work specified above. -
Engineer Name and Signature
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Position