Information
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Prepared by
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Conducted on
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Location description (to match order)
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Location (from GPS)
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Job number.
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SOS number.
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Nature of site
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Speed limit
- 20
- 30
- 40
- 50
- 60
- 70
Site Nature
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Traffic Management
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Diversion in place
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Weather
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Dual Carriageway (up to 40mph)
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Roundabout
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Proximity to junction
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Within 50 meters of controlled crossing (traffic lights/zebra crossing etc.)
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Evidence of utilities apparatus
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Anglian water
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Please provide photo of apparatus
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Transco
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Please provide photo of apparatus
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UK Power Networks
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Please provide photo of apparatus
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British Telecom
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Please provide photo of apparatus
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Virgin media
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Please provide photo of apparatus
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Other
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Please provide photo of apparatus
Specific Methods
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The following generic risk assessment list details generic risks identified and the control measures to be implemented as part of these works
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HS 01 Abrasive wheels and disc cutters
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HS 02 Animal and bird remains - removal from highway
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HS 03 Wet cell - Batteries
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HS 04 Biological and chemical hazards
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HS 05 Bitumen boilers
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HS 06 Chainsaws
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HS 07 Confined spaces
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HS 08 Coring rig
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HS 09 Drainage operations
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HS 10 Driving
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HS 11 Electrical tools
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HS 12 Emergency out of hours call out
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HS 13 Emergency pothole repairs
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HS 14 Excavations
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HS 15 Excavators 180 and 360
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HS 16 Gully emptying
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HS 17 Hand tools
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HS 18 Hot boxes
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HS 19 Hydraulic equipment
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HS 20 Incident report
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HS 21 Jet patcher operations
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HS 22 Kerb and slab laying
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HS 23 Kerr pins and setting out stakes
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HS 24 Leptospirosis
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HS 25 Lifting accessories
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HS 26 Lifting equipment
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HS 27 Livestock and animals - working near to
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HS 28 Loading plant and vehicles including trailers
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HS 29 ???
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HS 30 Manual handling
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HS 31 Noise
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HS 32 Noxious weeds
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HS 33 Patching and resurfacing
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HS 34 Pigeon dropping
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HS 35 Plant - drivable and ride on
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HS 36 Pneumatic equipment
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HS 37 Reversing vehicles
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HS 38 Road marking operations
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HS 39 Road sweeper operations
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HS 40 Safety fencing (VRS)
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HS 41 Service avoidance
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HS 42 Service avoidance underground services
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HS 43 Sharps (needles)
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HS 44 Signpost erection and maintenance
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HS 45 Small plant (powered)
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HS 46 Street lighting
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HS 47 Structures inspection
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HS 48 Tower lights
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HS 49 Traffic management
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HS 50 Use of chippers and crushers
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HS 51 Vibration (HAV)
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HS 52 Water - working on, over or near
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HS 53 Winter maintenance
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HS 54 Working on the highway
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HS 55 Working at height - ladders
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HS 56 Working at height - MEWP's
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HS 57 Working at height - scaffolding
Authorisation
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On inspection of the site and the detailed scope of works provided I have reviewed the GRA's highlighted. I can confirm that all lists are listed and the relevant control measures are in place to ensure safe working practice prior to the commencement of works.
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Inspectors authorisation
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On inspection of the site and the detailed scope of works provided I have reviewed the GRA's highlighted. further risks have been identified which will be controlled through the POINT OF WORK ASSESSMENT (attached). I confirm that both the GRA and POW control measures are in palace to ensure safe working practice prior to the commencement of works
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Depot authorisation