Title Page
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Site conducted
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Conducted on
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Prepared by
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Site Name
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Sector Name
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Location
Point of Work Risk Assessment
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Is Signing, Lighting and Guarding set up correctly, fully enclosing the site?
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Is there a Client Courtesy/Permit Board on display?
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Is all working equipment and materials contained within barriered off area?
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Are any of our works creating a trip hazard for Members of Public?
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Is the Job Pack/Works Instruction on site?
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Is the generic RAMS pack on site?
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Has Manual Handling been considered for the task?
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Has the works vehicle had a daily check and parked considerately?
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Is work equipment working and calibrated (GDU)?
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Is there any working at height?
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Has Ladder/Steps undergone a pre-use inspection?
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Is all PPE Clean, suitable, fit for purpose and worn correctly? (Safety Boots, CFL Branded Hi Viz etc)?
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Are there any additional hazards? (Outside School, Busy Road Crossing, Inclement weather etc)?
Duct section
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Start Location
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Duct section clear
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Civils Avoidance possible
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Type of avoidance
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From which pole to which pole.
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please supply image of reroute
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Please supply image of bypass route
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Please provide location of blockages
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Pavement width
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TM Required
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Comments
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Please supply images of rope at start and end points
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End Location
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Meterage completed