Title Page
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Conducted on
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Prepared by
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Job Number
Project Information
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Please enter the project name and number
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Please enter the project address:
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Who is the Client for this project?
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Who is the Principal Contractor for this project?
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Who is the site contact?
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Please enter the site contact telephone number:
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Please enter the site contact email address:
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Please enter project start date
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Please enter expected project completion date
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Project duration and number of phases if applicable
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Is a section 81 demolition notice required for this project?
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if yes, who is responsible for submitting Section 80 application?
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Has section 80 application been submitted to the local authority?
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Has section 81 notice been returned by the local authority?
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Is an F10 notification required for this project?
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If yes, who is responsible for submitting the F10 notification?
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Are there drawings or plans available for this project?
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If yes, what type of drawings or plans are available?
- As Built
- Drainage
- Gas
- Electricity
- Water
- Telecoms
- Data
Demolition Scope
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Slab Depth
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Foundation Depth
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Crush Onsite
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Drainage cut off and removal
Asbestos Removal
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Is Asbestos removal required on this project?
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If yes, who is responsible for undertaking the removal works?
- Horizon Envionmental Ltd.
- Principal Contractor
- Other
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If no, has Asbestos removal been undertaken by others prior to GDL works Commencing?
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If yes, has a stage 4 air clearence certificate been issued ?
Services
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Are overhead services present?
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If yes, please give details:
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Has the client arranged for service disconnections to be undertaken?
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If no, give details of any further action required:
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If yes, are isolation certificates available?
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If no, give details of further action required:
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If yes, please select which isolation certificates have been provided from the drop down menu
- Water
- Gas
- Electricity
- Telecoms
- Data
- Fibre Optics
- Other
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Is there a gas meter present?
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If yes, please give details: (service provider, location, meter number etc.)
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Please give current meter reading:
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Is there an electricity meter present?
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If yes, please give details: (service provider, location, meter number etc.)
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Please give current meter reading:
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Is there a water meter present?
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If yes, please give details: (service provider, location, meter number etc.)
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Please give current meter reading:
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Is there a fire hydrant nearby?
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If yes, please give details: (location, suitability for use as dust suppression supply, etc.)
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Please select the option form the drop down menu that best describes the water pressure:
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Will a hydrant licence be required?
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If yes, who is responsible for obtaining hydrant licence?
Live Services
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Is work in close proximity to live services required?
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If yes, what type of services are present?
- Water
- Gas
- Electricity
- Telecoms
- Data
- Fibre Optics
- Other
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Who is responsible for providing protection?
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Has the client been provided with and signed the GDL disclaimer document?
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Will extra time on program be required?
Surveys
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Is a survey for unknown utility services required on this project?
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If yes, who is responsible for commissioning unknown utilities survey?
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Has an R&D Asbestos survey been undertaken on this project?
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If No, who is responsible for commissioning R&D Asbestos survey?
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Is a drainage survey required on this project?
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If yes, who is responsible for commissioning drainage survey?
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Is an UXO survey required on this project?
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If yes, who is responsible for commissioning UXO survey?
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Is there potential for contaminated soil on this project?
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If yes, who is responsible for commissioning soil sampling?
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Are any additional surveys not listed above required on this project
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If yes, please give details:
Temporary Works
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Are temporary works required on this project?
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If yes, what temporary works are required? (please select all relevant options from the dropdown menu)
- Fixed Scaffold (TG 20:13)
- Fixed Scaffold (Design Required)
- Propping
- Hoarding
- Heras Fencing (where wind loaded)
- Excavation Support Systems
- Crash Decking
- Falsework
- Formwork
- Façade Retention
- Piling Mat
- Crane Mat
- Excavator Ramp and Pad
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Who is responsible for appointing the Temporary Works Coordinator (TWC) for this project?
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Please enter name of TWC
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PLease enter contact telephone number for TWC
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Please enter email address for TWC
Welfare
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Who is responsible for providing welfare on this project?
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Where GDL are responsible what type of welfare units are required?
- 24' x 9' Oasis Unit
- 20' x 8' Oasis Unit
- 16' Towable Unit
- 2 + 1 Toilet Block
- ½ Office x ½ Storage Unit
- 20' Office
- 20' Canteen
- 20' Storage Unit
- 10' Storage Unit
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What type of sewage removal is required?
Access
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Are there any width restrictions in relation to access? (f yes please take photographs and give details)
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Are the any height restrictions in relation to access? (f yes please take photographs and give details)
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Are there any weight restrictions in relation to access? (f yes please take photographs and give details)
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What type of parking is available on this project?
Highways
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Is a Skip Licence required? (7 days notice required prior to start date)
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Is a scaffold licence required? (7 days notice required prior to start date)
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Is a hoarding licence required? (7 days notice required prior to start date)
Plant
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What plant is required for this project?
- Demolition Excavator
- High Reach Excavator
- Straight Stick Excavator
- Forward Tipping Dumper
- Rear Tipping Dumper (Moxy)
- Crusher
- Screener
- Dust Buster
- 'Cherry Picker' MEWP
- 'Scissor Lift' MEWP
- Mobile Crane
- Crawler Crane
- Generator
- Fuel Bowser
- Lighting Tower
- Tractor and Bowser
- Roller
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Wher a demolition excavator is required what capacity would be best suited to the works?
- Mini Excavator
- 14 Tonne
- 20 Tonne
- 25 tonne
- 30 Tonne
- 35 tonne
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Is any specialist plant required for this project?
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If yes, please give details:
Material Salvage and Recycling
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Is there potential for material salvage on this project?
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If yes, please select materials to be salvaged form the drop down menu:
- Bricks
- Slates
- Kent Peg Tiles
- Floor Boards
- Joists
- Roof Boarding
- Chimneys
- Radiators
- Fireplaces
- Sash Windows
- Architectural Ironmongery
- Architectural Lighting
- Architectural Plaster Features
- Doors
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If yes, has a test for the presence of coal tar been undertaken?
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If yes, please give details:
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Who is responsible for organising quality testing on the crushed material?
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What is to happen with the end crushed material product?
- Leave on site for use by client
- Export from site
Environmental
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Is there a requirement for tree works to be undertaken on this project?
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If yes, please select the type of tree works from the drop down menu
- Felling
- Pollarding
- Pruning
- Topping
- Crown Reduction
- Crown Tninning
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Who is responsible for organising the tree works?
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Are there any Tree Preservation Orders in place?
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If yes, please give details:
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Is the set up of a tree protection zone required?
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If yes, please give details:
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Is a tree root protection zone required?
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If yes, please give details:
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Are drawings available of proposed tree and root protection zones?
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Do tree roots extend beyond the site boundary?
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Is there a requirement for green waste to be removed from site?
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If yes, who is responsible for the removal of green waste?
Environmental Surveys
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Has an ecological survey been undertaken for this project?
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If no, who is responsible for commissioning ecological survey?
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If yes have any invasive plant species been identified?
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If yes, please select species identified from the drop down menu:
- Giant Hogweed
- Japanese Knotweed
- Rhododendron Ponticum
- Himalayan Balsam
- New Zealand Pigmyweed
- Duck Weed
- Tree Groundsel
- Carolina Fanwort
- Water Hyacinth
- Water Primrose
- American Skunk Cabbage
- Parthenium Weed
- Kudzu
- Milkweed
- Nuttall's Waterweed
- Chilean Rhubarb
- Crimson Fountain Grass
- Horse Tail Weed
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Is the site considered to be located within an area of specific environmental concern?
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If yes, please select the most appropriate option form the drop down menu:
- Area of Special Scientific Interest
- Area of Outstanding Natural Beauty
- Preservation Area
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Has a habitat survey been undertaken for this project?
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If no, who is responsible for commissioning habitat survey?
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If yes, please select endangered species identified in survey from the drop down menu:
- Bats
- Newts
- Frogs
- Natterjack Toads
- Slow Worms
- Badgers
- Nesting Birds
- Birds of Prey
- Small Mammals of Note
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Are there any watercourses in close proximity to this project?
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If yes, are protection measures required?
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If yes, please give details below?
COSHH
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Are there any inherited COSHH items (chemicals, oils, etc.) which require specialist disposal?
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If yes, please give details of COSHH items identified for removal:
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Who is responsible for orgainising the removal of the COSHH items listed above?
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Are there any fuel tanks which require removal?
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If yes, have they been previously emptied, degassed and a certificate of cleanliness issued?
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If no, who is responsible for engaging a specialist subcontractor to undertake these works?
Environmental Monitoring
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Is there a requirement for environmental monitoring to be undertaken on this project?
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If yes, who is responsible for undertaking environmental monitoring?
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Where GDL are responsible, please select monitoring categories from the drop down menu:
- Noise
- Dust
- Vibration
Waste Notes
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Are waste notes compliant? (Please select a minmum of 3 waste notes and check that they have been completed correctly, ensuring that you include photographs)
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If Non-Compliant please give details of compliance failings
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Have the waste notes sampled been entered in the onsite waste material checklist?
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If no please give details
Sign off
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Once you have completed all mandatory sections the checklist in full, please sign below.
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Signature