Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Contract Manager
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Contract manager
Site
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Site Address:
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Photo of front of property
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Parking?
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Photo of parking
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Driveway?
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Photo of driveway
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Yellow lines locally?
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Photo of local road
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Pay and Display?
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Photo of ticket machine
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Red route?
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Sketch of parking
Client & Tenant details
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Term Client?
- Greenwich
- Old Ford
- Merton
- South Anglia
- Roddons
- Circle 33
- Mercian
- RDS
- GBNS
- Environtec
- Ford
- Freedom
- UKPN
- Ayerst
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Client?
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Client Contact Details (email, telephone etc.)
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Tenants details - name?
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Telephone No.
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Diversity issues?
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Comments?
Supervisor and working hours
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Preferred site supervisor?
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Working hours?
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Weekend working?
Analytical information and survey details
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Preferred analytical company?
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Type of air monitoring required?
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Give details of required monitoring
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Asbestos survey type
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Survey conducted by?
Asbestos information
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Type of asbestos
- None
- Asbestos Coating
- Insulation
- AIB
- Cement
- Artex
- Floor tiles
- Rope
- bitumen
- Durasteel
- Paper
- Bakelite
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Location of asbestos to be removed
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Condition of ACM
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Quantity of ACM to be removed (sq m)
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Removal method?
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Notes about removal method
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How is ACM fixed?
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Photo of ACM
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ACM painted / covered
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Photo of covering
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Are there any obstructions or obstacles (pipes etc.)
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Photo of obstruction
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Are there any items attached to the ACM?
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Photo of attached item
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Does the attached item need to be saved or re-used
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Photo of item to be saved
DCU & Transit route
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Location of DCU and surrounding landmarks
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Will DCU be attached?
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Type?
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Photo of location
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Mains feed location?
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Photo of mains feed
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Electric supply on site?
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Photo of electric supply
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Where will leads / cables run?
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Photo of location
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Type of water disposal?
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Photo of drainage location
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Transit route details?
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Photo of transit route
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Any obstacle or hazard on route?
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Photo of obstacle
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How long is transit route?
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Does transit route cross roads / pavements?
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Photo of road or pavement
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Escorted transit route required?
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Welfare facilities required?
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Photo of welfare location
Waste
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Waste disposal method
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Quantity (bags, kilos, skips)?
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Location of waste storage / issues?
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Photo of waste storage location
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Photo of issue
Enclosure
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Enclosure Length. Width. Height
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Area 1:
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Area 2:
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Area 3:
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Area 4:
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Area 5:
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Location
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Will the enclosure obstruct access within the building (toilet / kitchen)?
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Photo of enclosure location
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Temporary lighting required?
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Where will power come from?
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Photo of power point / generator location
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Is the work in a communal area?
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Photo of communal area
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If other tenants are affected please provide their contact details
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Do any vents need covering (if connected to a boiler this will need isolating)?
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Photo of vent / boiler
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Do windows need covering?
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Photo of windows
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If neighbours are affected by the enclosure please note their address
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Are there any problems with vegetation?
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Photo of vegetation
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Any other obstacles / obstructions need to be considered?
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Photo of obstruction
Air locks / Bag lock
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Access issues?
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Size of air lock
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Size of bag lock
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Vision panels or CCTV
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Will vision panels be accessible?
CDM Information
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CDM project
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Name of principle contractor?
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Name of CDMC
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Name of companies employer
COSHH
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Wet strip solution
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Aerosol adhesive
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Expanding foam
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MMMF
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General dusts
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Smoke fluid
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Soy gel paint remover
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X- tex paint remover
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Any other material?
Risk assessments
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Statutory services still live
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Confined space
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Noise and noise nuisance
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Hand demolition and hand arm vibration
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Hand cutting timber
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Manual handling
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Fire
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Handling asbestos cement sheet
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Removal of AIB
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Removal works within a live TC
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Working at height
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Cutting and removing asbestos pipe lagging
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Needles and sharps
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Grit blasting inside enclosure
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Use of airline respiratory equipment
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Use of injection equipment
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Material Transport and traffic management
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Vehicle entering and leaving site
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Disease from vermin
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Fuel or oil leaks from plant
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Hot works - cutting
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Use of mobile tower
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Hand tool use
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Erection of asbestos enclosures
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Fixed scaffold erection and modification
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Asbestos cement containing materials
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Use of machinery
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Removal of fluorescent tube light fittings
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Working from MEWPS
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Ice blasting inside enclosures
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Use of hand held power tools
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Use of podium steps
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Risk assessment notes
Access
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Height
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Is fixed scaffold required
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Mobile tower (height / number)
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Podiums (height / number)
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Ladder (loft access)
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Key code
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Void key
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Any other access issues
Sketch plan
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Must include, location of DCU, waste van / skip, air lock / bag lock, vacs, NPU, transit route, vision panels, CCTV, welfare. Additional equipment:red box, generators, towers, MEWPS, podiums
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Site sketch
Tenant agreement
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If required has furniture removal been explained and agreed?
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Does the tenant understand the works and what is involved in carrying them out?
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Has use of power / services been agreed with tenant
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If the tenant is leaving the property, has key handover times been agreed?
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Date of removal agreed with tenant / office?
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Date for removal
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Additional information?
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Tenants signature
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Erith representatives signature