Title Page
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Special Job Instructions for (Name of client and/or venue)
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Completed on
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By
Work Details
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Date of Visit
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Ref No
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Task - Brief Outline
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Site address and postcode
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Contact Name
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Contact Number
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Contact email address
Work Instructions
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Estimated work days/hours and numbers of people required for the task
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In Hours works?
Method of Work
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Step 1
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Task photos
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Step 2
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Task photos
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Step 3
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Task photos
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Step 4
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Task photos
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Step 5
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Task photos
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Step 6
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Task photos
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Cable route in the - From/To/Via
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Cable Route photographs
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Equipment list
Safety
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Are RA/MS required?
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Significant hazard
- WAH - MEWP
- WAH - Tilt Column
- WAH - Scaffold Tower
- WAH - Podium
- WAH - Step/Ladders
- Electricity - High risk
- Electricity - Low risk
- Manual Handling
- Slips, Trips or Falls
- Special Conditions - Construction
- Special Conditions - Rail
- Special Conditions - Utilities
- Special Conditions - Other
- Hazards - Other
- Hazards - Other
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Hazard photos
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Hazard notes
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Significant hazard
- WAH - MEWP
- WAH - Tilt Column
- WAH - Scaffold Tower
- WAH - Podium
- WAH - Step/Ladders
- Electricity - High risk
- Electricity - Low risk
- Manual Handling
- Slips, Trips or Falls
- Special Conditions - Construction
- Special Conditions - Rail
- Special Conditions - Utilities
- Special Conditions - Other
- Hazards - Other
- Hazards - Other
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Hazard photos
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Hazard notes
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Significant hazard
- WAH - MEWP
- WAH - Tilt Column
- WAH - Scaffold Tower
- WAH - Podium
- WAH - Step/Ladders
- Electricity - High risk
- Electricity - Low risk
- Manual Handling
- Slips, Trips or Falls
- Special Conditions - Construction
- Special Conditions - Rail
- Special Conditions - Utilities
- Special Conditions - Other
- Hazards - Other
- Hazards - Other
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Hazard photos
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Hazard notes
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Client instruction or additional notes on the works
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Add signature
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Forward to Admin so a quote and RA/MS can be completed.
