NW Duty Officer Handover Form (Safety)V1

• Conducted on

  Date

• Prepared by

• Location
  Address

• Team/Engineer

• Supervisor that requires information.

• Job Type

• Reason For Handover

• Safety Information MUST be recorded by Field Force in GDFO. Has this been completed?

  Yes

  No

  N/A

3rd Party Information

• 3rd party attended site?

  Yes

  No

  N/A

• Who?

• Why?

Reporting Requirements

• RIDDOR

  Required

  Not Required

  Complete

• GSMR

  Required

  Not Required

  Complete

• NGIS

  Required

  Not Required

  Complete

• Other?

Site Information

• Hazards on Site

• Other Information (evacuations/readings etc)

• Describe further work required

• What Safe System of Work has already been discussed?

• Additional safety critical Information

Rest Time (Hours)

• Team

• FCO

• You

• Others

PLEASE ENSURE THIS IS SHARED VIA PDF .box.NWRepairPlanningTeam

• OK