Title Page

  • Site Name

  • Address

  • Operator Ref

  • Date and Time

  • Company

  • Prepared by

Site Information

  • Which operators have equipment on site?

Operator equipment

  • How many antennas are installed? (Refer to As Built drawings for shrouded monopoles)

  • How many dishes are installed?

  • How many cabinets are installed (excluding the RFE's)?

  • Is any other equipment installed on site? (e.g. RRUs, MHAs, DTMAs etc.)

  • Please list any additional equipment (including quantity and location)

  • Please provide a description and photographs of any equipment on site.

  • Has the lightning protection been tested?

  • Date of LP Certificate

  • Did the Lightning Protection pass inspection?

  • Please provide details

  • Fall Arrest Certificate complete?

  • Date of Fall Arrest Certificate

  • Did the Fall Arrest pass inspection?

  • Please provide details

PPM Visit Report

  • INSTRUCTIONS

    1. Please answer all questions.
    2. Add photos and notes by clicking on the paperclip icon.
    3. Complete audit by providing digital signature.
    4. Share your report by exporting as PDF.

1 - Site Access

  • Please include pictures of the access route from the road/carpark to the site

  • 1.1 - Can the site be accessed following the access route shown on the drawings?

  • 1.2 - Is there adequate lighting along the access route?

  • 1.3 - Is the access route to site clear of obstacles?

  • 1.4 - Are there any drainage issues to prevent year round site access?

  • 1.5 - Is there adequate vehicle access and safe parking?

  • 1.6 - What is the condition of the access gate?

  • 1.7 - What is the general condition of the access track?

  • 1.8 - Is this the first PPM visit completed at this site?

  • 1.9 - What is the condition of the power and or fibre route reinstatement?

  • 1.10 - General Comments

2 - Trees

  • 2.1 - Are there localized trees within the " Fall Zone" of site?

  • 2.2 - Please supply photos of trees around the site and compound

  • 2.3 - What is the approximate height of the trees (m)?

  • 2.4 - What is the distance of the trees from the site (m)?

  • 2.5 - Are there any overhanging branches near the site?

  • 2.6 - Are there any signs of damage to the tree trunk or main branches of trees near to the site?

  • 2.7 - Is there any remedial actions required?

3 - Site/Compound

  • Please provide pictures of the site/compound

  • 3.1 - Is this site fenced?

  • 3.2 - Is a combination padlock on the gate installed?

  • 3.3 Please provide the new padlock code (Note: the Access Team will provide a new code on the day of the visit, please call 0044 1590 670025 if no codes have been provided)

  • 3.4 - Are the fence posts secure, stable and in good condition?

  • 3.5 - Do the gate pins, bolt & socket allow the gate to operate smoothly?

  • 3.6 - Is the fence in good condition?

  • 3.7 - Are all barriers/bollards/handrails in good condition?

  • 3.8 - Is there any evidence of water ponding on concrete surfaces?

  • 3.9 - Is the concrete damaged at any location?

  • 3.10 - Is the site free from slips, trips and fall hazards?

  • 3.11 - Is the site/compound free from waste, vegetation, vermin/pest infestations?

  • 3.12 - Has weed killer been applied where required?

  • 3.13 - Is the equipment installed as per the drawings?

  • 3.14 - Are covers fitted to cable ladders / trays where cables are likely to be stepped across?

  • 3.15 - Are there cable management systems installed and used correctly?

  • 3.16 - General comments

4 - Operator Cabinets

  • Please provide pictures of the cabinets

  • 4.1 - Are all cabinet doors & panels secure and locked?

  • 4.2 - Are all cabinets the correct type & colour?

  • 4.3 - Is the external condition of the enclosure & finish acceptable with no signs of damage?

  • 4.4 Is the cabinet sealed where it meets the concrete and plinth/root?

  • 4.5 - General comments

5 - Electrical Installation

  • Please provide pictures of RFE's and DB's

  • 5.1 - What is the condition of the distribution board?

  • 5.2 - Are there any signs of water ingress into the RFE or DB's?

  • 5.3 - Are the doors securely lockable on the RFE and DB's?

  • 5.4 - Is the ESB equipment in good visual condition?

  • 5.5 - Are all devices in the RFE / DB labelled correctly?

  • 5.6 - Are all ducts foamed and sealed?

  • 5.7 - Are all unused cable glands sealed?

  • 5.8 - Are all covers fitted securely to all live parts?

  • 5.9 - Meter reading:

  • 5.10 - Meter serial no:

  • 5.11 - General comments

6 - Lightning Protection

  • Please provide pictures of the LP installation

  • 6.1 - Is lightning protection installed as per the drawings?

  • 6.2 - Is there LP bonding to compound/ fence?

  • 6.3 - Is there LP bonding to the structure?

  • 6.4 - Are all steelwork items including gantry poles bonded to the LPS?

  • 6.5 - Is the LP surface mounted/visible?

  • 6.6 - Are all exposed earthing tapes PVC coated?

  • 6.7 - Are all earthing tape runs straight?

  • 6.8 - Are all changes in direction 90deg with proprietary joints?

  • 6.9 - Are earth tapes labelled in earth pits?

  • 6.10 - Has contact paste been applied to all external LP connections

  • 6.11 - General comments

7 - Structure

  • Please provide pictures of the structure

  • 7.1 Is the structure vertical?

  • 7.2 - Does the galvanising/painted finish appear in good condition?

  • 7.3 - Are there any visible signs of damage/cracks/corrosion on the structure?

  • 7.4 - Are the access hatches secure?

  • 7.5 - Are the holding down bolts visible?

  • 7.6- Is there any damage/cracks/corrosion to the nuts, and bolts including holding down bolts?

  • 7.7 - Are the holding bolts secure and tight? Refer to manufacturers guidelines

  • 7.8 - Are all bolts the correct length?

  • 7.9 - Are flat and spring washer fitted according to manufacturers guidelines?

  • 7.10 - Have all bolt torque checks been completed in line with manufacturers recommendations?

  • 7.11 - Are all welds at the base of the structure free from cracks?

  • 7.12 - Are all antennas, MHA's, RRU's and combiners correctly secured?

  • 7.13 - Are all dish/GPS/CCTV brackets in good working order with no visible signs of corrosion?

  • 7.14 - Is all operator equipment secured with a minimum of 4No. U bolts and plates fixed to the structural elements of the tower

  • 7.15 - Are all operator stand off poles vertical and secure?

  • 7.16 - Are there any jubilee clips used to support operator equipment

  • 7.17 - Has a full inventory audit of the operator equipment been completed?

  • 7.18 - Is the structure designed to be a climbable structure?

  • 7.19 - Has the fall arrest system been installed as per the manufacturers recommendations?

  • 7.20 - Is the system tagged & in date?

  • 7.21 - Is the structure safe to climb?

  • 7.22 - Is an anti-climb guard installed with combi padlock fitted & functional?

  • 7.23 - Please provide the new padlock code (Note: the Access Team will provide a new code on the day of the visit, please call 0044 1590 670025 if no codes have been provided)

  • 7.24 - What is the condition of the system / cable?

  • 7.25 - Are all lanyard hoops in place and secured on all designated working platforms?

  • 7.26 - Is there any damage to the ladder?

  • 7.27 - Any excess steel/bars causing hazard to personal whilst climbing?

  • 7.28 - Are there floodlights installed on the structure?

  • 7.29 - How many lamps are installed?

  • 7.30 - Is the floodlight bracket in good condition?

  • 7.31- Is the bracket installed at the height shown on the drawings?

  • 7.32 - General comments

8 - Signage

  • Please provide pictures of all site signage

  • 8.1 - Has Shared Access H&S signage been installed on the structure?

  • 8.2 - Has Shared Access H&S signage been installed on the compound gate?

  • 8.3 - Is all operator signage installed as per the drawings?

  • 8.4 - Has electrical warning signage been installed on all RFE's and Operator DB's?

  • 8.5 - Has all operator (OP1, OP2, OP3) signage been installed on RFE's and operator DB's?

  • 8.6 - General comments

9 - Other

  • 9.1 - Have any padlocks been replaced?

  • 9.2 - How many new padlocks have been replaced?

  • 9.3 - Have any signs been replaced?

  • Please detail the signs that have been installed

  • Please include any other information that needs highlighting here

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.