Title Page
-
SR Number:
-
Work Order Number:
-
Building
-
Location
Access Attempts
-
Access acquired?
-
Access Attempts - Dates & Times
-
Add signature
Risk Assessment
-
Asbestos Register Checked
-
Please check the Asbestos Register before proceeding with any penetrative works.
-
Persons who could be exposed to Asbestos? (Not applicable if Asbestos is not present)
-
Works to be carried out?
-
Any hazard(s) Identified
-
What hazard(s) have been identified?
-
Risk Guidance Assessment Number
-
Task Specific Risk Assessment - Likelihood
-
Task Specific Risk Assessment - Severity
-
Risk - Likelihood x Severity
-
Control Measures
- Score = 1 -3 Proceed with works
- Score = 4 - 6 List control measures in place
- Score - 7 - 9 Refer to line manager for further advice.
-
Control Measures Required
Works Carried Out
-
Signed into building?
-
What is the problem?
-
Barrack Damage
-
Brief description of the damage.
-
Picture of damage
-
Asset Number if available?
Works Status
-
Works Completed
-
undefined
- No fault found
- Over the Cap Cost
- Condition restored only
- Fair wear & tear
- Could not replace like for like
-
Works not completed?
-
undefined
- Waiting for Materials
- No Access
- Could not replace like for like
Stock & Materials
-
Part No / PO No.
-
Part Description
-
Qty Used
Asset Condition
-
Condition type:
- New
- Acceptable
- Poor
-
After picture
Signatures
-
Operatives Name
-
Time spent on Job? (Hr / Min)
-
Date & Time
-
Signature
-
Note : Before commencing any additional work, contact Supervisor for authority to proceed and enter details on blank worksheet.