Title Page

  • Client / Site / Ref No

  • Site Address
  • Site Contact

  • Document No.

  • Date of Inspections

  • Time on site

  • Time off site

  • Persons conducting inspection

  • ⚠️ Before commencing work please ensure all Health & Safety procedures have been implemented, including Permission from the owner of the take-off point, setting up of exclusion zones and weather checks before takeoff.

  • Tick box to confirm you have implemented all applicable H&S procedures and obtained a Working at Height Permit where applicable

  • Gutters & downpipe systems inspected for signs of damage or leaks

  • Gutters inspected internally and photo record taken

  • Gutter cleaning / clearing carried out

  • Gully inspected and cleaned if required

  • Rainwater outlet covers (e.g. Wire balloon) in place

  • Are there leaves from adjacent trees which might necessitate a further visit

  • Is there any additional work required

  • Comments

  • Operative 2

  • Operative 1

  • Site Representative

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.