Access
Address
Access Issues
Works detail
Assessed priority
Nature of Works
NC1
NC2
NC3
NC4
NC1
NC2
NC3
NC4
Self Rescue
Assisted Rescue
• Loss of consciousness arising from gas, fumes, vapours or the lack of oxygen
• Loss of consciousness arising from an increase in body temperature
• Serious injury arising from a fire or explosion
• Drowning from an increase in the level of liquid
• Asphyxiation from a free flowing solid or inability to reach a respirable atmosphere due to entrapment in a free flowing solid.
Approx length
Summary of findings
Silt sample required?
Number of men required for task
Inlet Structure
Comments
Comments
Height (mm)
Width (mm)
Water depth (mm)
Material
Approx silt depth at inlet (mm)
Additional notes
Overhead services
Type of land
Restrictions & contact numbers
Off road parking?
Soft / uneven ground?
Stock present?
Traffic Management
Restrictions / directions
Is there a bridge restricting access?
Outlet structure
Comments
Comments
Height (mm)
Width (mm)
Water depth (mm)
Material
Approx silt depth at outlet (mm)
Additional notes
Overhead services
Type of land
Restrictions & contact numbers
Off road parking?
Soft / uneven ground?
Live stock present?
Traffic management
Restrictions / directions
Is there a bridge restricting access?
Additional photographs
Note
Note
Note
Note
Note
Notes
Pollution & environmental control
Environmental or pollution Control Matters which might effect the risk Assessment .
Any other matters relevant to the risk Assessment ?
Sign off
