Information
PLEASE COMPLETE THIS SECTION IN BLOCK CAPITALS - DOUBLE TAP ON SHIFT KEY MAKES BLOCK CAPS
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JOB TITLE e.g. SITE NAME - EQUIPMENT / LIFT / BUILDING NAME - JOB 9999
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SITE NAME
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ENGINEER
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Conducted on
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Location
JOB REFERENCE / DESCRIPTION
USEFUL SITE / LIFT INFORMATION
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E. G. DOOR CODES / AUTODIALLERS / CONTACT INFO / OTHER USEFUL INFO...
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PLEASE TAKE ANY USEFUL REFERENCE PHOTOS FOR IDENTIFICATION / USEFUL NUMBERS etc
GROUPS OF PERSONS AT RISK
JOB LOCATION
FREQUENCY AND DURATION OF ACTIVITY
ADDITIONAL SPECIFIC HAZARDS IDENTIFIED
ADDITIONAL CONTROL METHODS REQUIRED
ASSESSMENT OF REMAINING RISKS
EMERGENCY ARRANGEMENTS
TAKE PHOTOS IF NEEDED
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Take Photos if required.
SIGNATURE
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Site Specific Assessment Completed by:
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DATE RISK ASSESSMENT COMPLETED