Title Page

  • Customer

  • Site address

  • Site Post code

  • Client site identity number

  • Time onsite

H&S detail checklist

  • Is there a risk of violence or abuse

  • Is there a risk of dangerous animals

  • Is lone working taking place

  • Is manual handling required

  • Is there evidence of drug abuse or environmental concerns

  • Are there vulnerable persons present

  • Does work involve works at height

  • Does the work involve flat roof work

  • Does the work involve pitched roof works

  • Does the task involve the use of leaning ladders or steps

  • Does the task involve loft works

  • Does the task require access of scaffold equipment

  • will the task generate excessive noise and dust

  • will the task lead to blocked exit/ and or fire route

  • Will members of the public be directly affected by the task

  • Does the task involve working in confined spaces

  • Does the task involve on mains electrical circuits

  • Does the task involve the use of COSHH items

  • Is the work likely to disturb any asbestos if present

  • will the work involve use of power tools

  • will the task involve working with fibre or sharps

  • will the work involve lifting pits

  • does the task require fall arrest equipment

  • does the task involve working in areas where ther is evidence of vermin

  • does the task involve working in areas of significant or equipment covered in bird droppings

  • have you taken hygiene precautions

Fault

  • Problem description

  • Works carried out

  • Further works required

  • Equipment In (including asset numbers)

  • Equipment Out (including asset numbers)

  • Job status

  • Time off site

Signatures

  • Customers Name

  • Customers Signature

  • Engineers Name

  • Engineers Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.