NOTE FROM ENGINEER

• SITE AND TYPE OF INFORMATION IN THIS NOTE

• LIFT DETAILS TO WHICH NOTE APPLIES TO

• ENGINEER

• Conducted on

  Date
• Location
  Address

• Prepared by

PLEASE ENSURE YOU GIVE DETAILS OF WHICH SITE / LIFT THESE NOTES REFER TO

NEW INFORMATION ABOUT SITE OR LIFT

• Details of any new Information about Site / Lift / New Procedures to Follow etc

• Take Photos as Needed

  Media

CODES / KEYS / ACCESS ARRANGEMENTS

• Details of any new Codes Keys or Access Arrangements for Site or Lift etc.

• Take Photos as Needed

  Media

REQUIRED INFORMATION

• Details of any information you have been asked to gather about Lift or Site e.g. Part Details etc

• Take Photos as Needed

  Media

RISK ASSESSMENT INFORMATION

• Is there a current Risk Assessment on Site

  Yes

  No

  N/A

• Do you think a new Risk Assessment needs to be completed?

  YES

  NO

  N/A

  SEE NOTES

• Does a Risk Assessment need to be placed on site

  YES

  NO

  N/A

  SEE NOTES

FURTHER WORK REQUIRED

• Details of any new or further work which may required to be done on site.

• Take Photos as Needed

  Media

ENGINEERS SIGNATURE

• Engineer - Please Print Name and Sign

  Sign