Maintenance Operatives Worksheet

• SR Number:

• Work Order Number:

• Building

  Select

• Location

Access Attempts

• Access acquired?

  Yes

  No

  N/A

• Access Attempts - Dates & Times

  Date

• Add signature

  Sign

Risk Assessment

• Asbestos Register Checked

  Yes

  No

  N/A

• 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)

  Employees

  Other Workers

  Building Users

  General Public

  N/A

• Works to be carried out?

• Any hazard(s) Identified

  Yes

  No

  N/A

• What hazard(s) have been identified?

• Risk Guidance Assessment Number

• Task Specific Risk Assessment - Likelihood

  One

  Two

  Three

• Task Specific Risk Assessment - Severity

  One

  Two

  Three

• Risk - Likelihood x Severity

• Control Measures

  Select Score = 1 -3 Proceed with works Score = 4 - 6 List control measures in place Score - 7 - 9 Refer to line manager for further advice.

  • 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

  Yes

  No

  N/A

Works Carried Out

• Signed into building?

  Yes

  No

  N/A

• What is the problem?

• Barrack Damage

  Yes

  No

  N/A

• Brief description of the damage.

• Picture of damage

  Media

• Asset Number if available?

Works Status

• Works Completed

• undefined

  Select No fault found Over the Cap Cost Condition restored only Fair wear & tear Could not replace like for like

  • No fault found
  • Over the Cap Cost
  • Condition restored only
  • Fair wear & tear
  • Could not replace like for like

• Works not completed?

• undefined

  Select Waiting for Materials No Access Could not replace like for like

  • 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:

  Select New Acceptable Poor

  • New
  • Acceptable
  • Poor

• After picture

  Media

Signatures

• Operatives Name

• Date & Time

  Date

• Signature

  Sign

• Note : Before commencing any additional work, contact Supervisor for authority to proceed and enter details on blank worksheet.