Job Sheet & CPP

• 1st Line of Address

• Engineer

• Date

  Date

• Work Order No

• Address details
  Address

CPP

• You are the Principal Contractor/Contractor for this work under CDM and responsible for ensuring the job runs safely. In order to do so, please complete the questions below which form the Construction Phase Plan (CPP)

• 1.Have you got the correct skills, knowledge, training and experience to complete this work?

  Yes

  No

• stop work and contact your line manager.
  
  This is the end of the form. Thank you for completing this - Please hand this to your Trade Supervisor within 48 hours of completion.

• 2. Have you considered the Northgate warnings of hazards present and taken action as necessary e.g. accessed the Asbestos Register, attended in pairs?

  Yes

  No

  N/A

• stop work and contact your line manager.
  
  This is the end of the form. Thank you for completing this - Please hand this to your Trade Supervisor within 48 hours of completion.

• 3. Are you aware of the emergency procedures for asbestos and lone working? (see GoodReader - CDM - Asbestos Emergency Procedure, Lone Working Procedure)

  Yes

  No

  N/A

• stop work and contact your line manager.
  
  This is the end of the form. Thank you for completing this - Please hand this to your Trade Supervisor within 48 hours of completion.

• 4. Have you familiarised yourself with the building to ensure you can escape in the event of a fire?

  Yes

  No

• stop work and contact your line manager.
  
  This is the end of the form. Thank you for completing this - Please hand this to your Trade Supervisor within 48 hours of completion.

• 5. Are you aware of the nearest toilet, washing basin (with hot and cold running water) and rest facilities and the nearest hospital? (see GoodReader - CDM - Welfare and Hospital Facilities)

  Yes

  No

• stop work and contact your line manager.
  
  This is the end of the form. Thank you for completing this - Please hand this to your Trade Supervisor within 48 hours of completion.

• 6. Are you aware of the hazards that relate to this work?

  Yes

  No

• stop work and contact your line manager.
  
  This is the end of the form. Thank you for completing this - Please hand this to your Trade Supervisor within 48 hours of completion.

• 7. Have you read and understood the risk assessments and method statements relevant to these hazards ? (see GoodReader - CDM - RAMS)

  Yes

  No

• stop work and contact your line manager.
  
  This is the end of the form. Thank you for completing this - Please hand this to your Trade Supervisor within 48 hours of completion.

• 8. Are all hazards included in these risk assessments and method statements?

  Yes

  No

• stop work and contact your line manager.
  
  This is the end of the form. Thank you for completing this - Please hand this to your Trade Supervisor within 48 hours of completion.

• 9a. Will you be using any hazardous substances or materials during the work?

  No

  Yes

• 9b. Have you read and understood the COSHH assessments relevant to these substances or materials? (see GoodReader - COSHH Assessments)

  Yes

  No

• stop work and contact your line manager.
  
  This is the end of the form. Thank you for completing this - Please hand this to your Trade Supervisor within 48 hours of completion.

• 10a. Will you be working with another operative?

  No

  Yes

• 10b. How will you communicate with them to ensure the job runs safely? - Please advise if the daily briefing before work starts, face to face as changes arise, written instruction e.g. email

• 10c. Have you provided them with details of any Northgate warnings of hazards and confirmed that they have taken action as necessary e.g. accessed the Asbestos Register, attended in pairs?

  Yes

  No

  N/A

• stop work and contact your line manager.
  
  This is the end of the form. Thank you for completing this - Please hand this to your Trade Supervisor within 48 hours of completion.

• 10d.Please confirm that you will provide them with details of this Construction Phase Plan

  Yes

  No

• stop work and contact your line manager.
  
  This is the end of the form. Thank you for completing this - Please hand this to your Trade Supervisor within 48 hours of completion.

• This is the end of the form. Thank you for completing this - Please hand this to your Trade Supervisor within 48 hours of completion.

• This is the end of the form. Thank you for completing this - Please hand this to your Trade Supervisor within 48 hours of completion.

• 10a. Will you be working with another operative?

  No

  Yes

• 10b. How will you communicate with them to ensure the job runs safely? - Please advise if the daily briefing before work starts, face to face as changes arise, written instruction e.g. email

• 10c. Have you provided them with details of any Northgate warnings of hazards and confirmed that they have taken action as necessary e.g. accessed the Asbestos Register, attended in pairs?

  Yes

  No

  N/A

• stop work and contact your line manager.
  
  This is the end of the form. Thank you for completing this - Please hand this to your Trade Supervisor within 48 hours of completion.

• 10d.Please confirm that you will provide them with details of this Construction Phase Plan

  Yes

  No

• stop work and contact your line manager.
  
  This is the end of the form. Thank you for completing this - Please hand this to your Trade Supervisor within 48 hours of completion

• This is the end of the form. Thank you for completing this - Please hand this to your Trade Supervisor within 48 hours of completion.

• This is the end of the form. Thank you for completing this - Please hand this to your Trade Supervisor within 48 hours of completion.

Worksheet details

• Job description

  Select No CH No HW Leak Cut & Cap Uncap and Service Supply temporary heat Survey Other Install

  • No CH
  • No HW
  • Leak
  • Cut & Cap
  • Uncap and Service
  • Supply temporary heat
  • Survey
  • Other
  • Install

• Work carried out

• SOR code

• Parts further work required

• Temporary heater accepted?

  Yes

  No

  N/A

• Number of heaters issued

Appliances

• Add appliance

Appliance details

• Appliance type

  Select Boiler BBU Cooker Fire Hob Other

  • Boiler
  • BBU
  • Cooker
  • Fire
  • Hob
  • Other

• Make

• Model

• Flue type

  RS

  OF

  FL

• Location

  Select Kitchen Airing cupboard Lounge Hall Bedroom Bathroom Compartment Cupboard Cellar Loft Utility Garage Other

  • Kitchen
  • Airing cupboard
  • Lounge
  • Hall
  • Bedroom
  • Bathroom
  • Compartment
  • Cupboard
  • Cellar
  • Loft
  • Utility
  • Garage
  • Other

• Operating pressure/ heat input

• Safety device ok

  Yes

  No

  N/A

• Ventilation ok

  Yes

  No

  N/A

• Flue visual ok

  Yes

  No

  N/A

• Flue performance checks ok

  Yes

  No

  N/A

• Tightness test satisfactory

  Yes

  No

  N/A

• Appliance safe to use

  Safe

  At Risk

  Immediately Dangerous

  N/A

• Job start time

  Date

• Finish time

  Date

• Operatives Signature

  Sign

• Customer Signature

  Sign