Information
-
Project Name and/or Nautical Roofing Job Number
-
Site Address
-
Conducted on
-
Person requesting variation
-
Nautical Supervisor
-
Document No.
Form
-
Attach photo of Site Instruction
-
Add relevant photos and annotate where needed.
-
What items are required for safety/access?
- Bollards
- Visual Barrier
- Travel Restraint
- Fall Arrest
- Rescue Kit
- Hand Rail
- Extension Ladder
- Platform Ladder
- Mobile Scaffold
- Scissor Lift
- Boom Lift
- Other
-
How many anchor points, ropes, static lines etc?
-
What form of rescue will be used for the Fall Arrest System?
-
Are all workers/supervisors trained in the use of the Gotcha Rescue Kit?
-
How many metres of Hand Rail and how will it be attached - steel, tilt panel, roof mount, eaves gutter etc?
-
What platform ladder height and quantity?
-
What deck height and width for mobile scaffold? (If over 4m a ticketed scaffolder needs to erect it)
-
What quantity, size, type, non-marking tyres, R-T scissor lift is required?
-
What quantity, size, type, non-marking tyres, boom lift is required?
-
If "other", please specify.
-
Are the areas for working, rail, EWPs, a safe distance from live power lines?
-
List all materials needed. Flashings, fixings, sheets, wool, etc.
-
Attach flashing orders or any relevant material orders.
-
List approximate labour required. How many men, hours/days.
-
What date does the work need to commence?
-
What date do the works need to be completed by?
-
Nautical Supervisor Signature
