Extraction Works Report

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Health and Safety

• Is all Electrical Equipment, Access Equipment, PPE and H&S Equipment up to Standard and suitable for Use?

  Yes

  No

• REPORT DEFECT TO YOUR LINE MANAGER

• What equipment is faulty? and discription of fault.

• Equipment ID

• Photo of equipment showing fault

  Media

• Who have you reported the issue too?

  Anthony Burrows

  Stephen Morgan

  Lee Gregory

  Other

• Name of person reported too?

Property Information

• Client Name

• Address
  Address

• Crew No.

  Select EVO1 EVO2 EVO3 EVO4 EVO5 EVO6 EVO7 EVO8 EVO9 EVO10 EVO11 EVO12 EVO13 EVO14 EVO15

  • EVO1
  • EVO2
  • EVO3
  • EVO4
  • EVO5
  • EVO6
  • EVO7
  • EVO8
  • EVO9
  • EVO10
  • EVO11
  • EVO12
  • EVO13
  • EVO14
  • EVO15

• Crew Leader Name

• Works Completed Date

  Date

Pre Commencement of Works

• Photo of each elevation of property before works commence

  Media

• Customer advised of the method of works

  Yes

  No

  N/A

• Is there evidence or is the customer aware of any electrical cables within the cavity?

  Yes

  No

  N/A

• Is the customer aware of any potential material ingress?

  Yes

  No

  N/A

• All windows closed to prevent dust ingress?

  Yes

  No

  N/A

• Are all air ventilators closed/temporary sealed to prevent ingress?

  Yes

  No

  N/A

• Items removed from window sills?

  Yes

  No

  N/A

• Cavity heads closed/sealed within the loft space to prevent ingress?

  Yes

  No

  N/A

• Are all vehicles and stored items removed from work areas?

  Yes

  No

  N/A

• Note position of DPC's and cavity trays to prevent drilling into them

  Yes

  No

  N/A

Post Works Completion Checks

• Confirm Elevations Extracted.

  Select Front Elevation Rear Elevation Left Elevation Right Elevation Extention

  • Front Elevation
  • Rear Elevation
  • Left Elevation
  • Right Elevation
  • Extention

• Photos of all elevations Post works.

  Media

• Photos of cavity on all elevations extracted Post works.

  Media

• Suspended/timber floor air ventilators clear/unobstructed?

  Yes

  No

  N/A

• Kitchen, bathroom, room ventilators clear/unobstructed?

  Yes

  No

  N/A

• Cupboards etc clear of dust/material ingress

  Yes

  No

  N/A

• Loft ventilation clear/unobstructed?

  Yes

  No

  N/A

• Making good of all drilling/extraction points complete and satisfactory?

  Yes

  No

  N/A

• Photos of all extraction points after work is completed and repointed.

  Media

• All windows, doors, drive and pathways cleaned down fully?

  Yes

  No

  N/A

• All debris and waste materials removed from site for disposal?

  Yes

  No

  N/A

• Photos of clean up (Pathways and Drives etc)

  Media

• Photos of variations (if applicable)

  Media

• General Comments

• Signature of Crew Leader

  Sign

• Signature of client to declare that I am happy with processes explained to me and the standard of the work carried out.

  Sign