Title Page
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Customer
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Site address
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Site Post code
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Client site identity number
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Time onsite
H&S detail checklist
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Is there a risk of violence or abuse
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Is there a risk of dangerous animals
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Is lone working taking place
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Is manual handling required
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Is there evidence of drug abuse or environmental concerns
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Are there vulnerable persons present
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Does work involve works at height
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Does the work involve flat roof work
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Does the work involve pitched roof works
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Does the task involve the use of leaning ladders or steps
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Does the task involve loft works
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Does the task require access of scaffold equipment
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will the task generate excessive noise and dust
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will the task lead to blocked exit/ and or fire route
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Will members of the public be directly affected by the task
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Does the task involve working in confined spaces
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Does the task involve on mains electrical circuits
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Does the task involve the use of COSHH items
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Is the work likely to disturb any asbestos if present
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will the work involve use of power tools
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will the task involve working with fibre or sharps
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will the work involve lifting pits
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does the task require fall arrest equipment
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does the task involve working in areas where ther is evidence of vermin
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does the task involve working in areas of significant or equipment covered in bird droppings
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have you taken hygiene precautions
Fault
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Problem description
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Works carried out
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Further works required
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Equipment In (including asset numbers)
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Equipment Out (including asset numbers)
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Job status
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Time off site
Signatures
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Customers Name
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Customers Signature
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Engineers Name
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Engineers Signature