PAIR Form Plant use

• Site conducted

  Select

• Full Name/Team/Contractor:

• Date:

  Date

• Prepared by:

• Project Title:

• ELR & Mileage:
  Address

• Is there OTP?

  Yes

  No

  N/A

• Is there an interaction with Civils plant?

  Yes

  No

  N/A

• Who is the plant Provider?

  Select QTS Quattro Readypower TXM Pro Rail Coombes Ground Control TRAC Elmec Solutions AB2000 Total Rail Solutions Van Elle Story Avondale Lundys Pod Trak Keltbray SES SPL Volker N/A Other Please Specify

  • QTS
  • Quattro
  • Readypower
  • TXM
  • Pro Rail
  • Coombes
  • Ground Control
  • TRAC
  • Elmec Solutions
  • AB2000
  • Total Rail Solutions
  • Van Elle
  • Story
  • Avondale
  • Lundys
  • Pod Trak
  • Keltbray
  • SES
  • SPL
  • Volker
  • N/A
  • Other Please Specify

• What is the type of plant?

  Select 360 Unimog Kubota Trailer Tractor Lorry HIAB Other Please Specify

  • 360
  • Unimog
  • Kubota
  • Trailer
  • Tractor
  • Lorry HIAB
  • Other Please Specify

• What is the safe system of work?

  Safeguarded

  fenced

  Separated

  Site Warden

  Lookout

• Host Machine LOLER In date and on site?

  Yes

  No

  N/A

• Pre - Start Checklist completed?

  Yes

  No

  N/A

• Loose Lifting Tackle in date and tagged?

  Yes

  No

  N/A

• Attachment LOLER in date?

  Yes

  No

  N/A

• Any Further Comments?

  Yes

  No

  N/A

• Lift plan on site and Correct?

  Yes

  No

  N/A

• ALO available and on site?

  Yes

  No

  N/A

• Briefed and signed?

  Yes

  No

  N/A

• MC/CC F027 Completed and signed?

  Yes

  No

  N/A

• OTP Plan on site and Signed?

  Yes

  No

  N/A

• POS Brief conducted and Signed?

  Yes

  No

  N/A

• Sentinel Checked and correct?

  Yes

  No

  N/A

• NPTC / CPCS / NPORS / City and Guilds present ?

  Yes

  No

  N/A

• Company Specific ATW On site and correct?

  Yes

  No

  N/A

• Duplex Communication used?

  Yes

  No

  N/A

• Test before touch witnessed?

  Yes

  No

  N/A

• Exclusion Zones briefed and adhered to?

  Yes

  No

  N/A

• Good Awareness of other plant is use throughout the site?

  Yes

  No

  N/A

• Is the Plant Sufficient and fit for the task?

  Yes

  No

  N/A

• Is there and on site Fitter?

  Yes

  No

  N/A

• What are the POS Rep arrangement?

  POS/CC/MC

  POS With stand alone MC/CCs

• RRAP Sufficient?

  Yes

  No

  N/A

• Storage area or haulage agreed?

  Yes

  No

  N/A

• Traffic Management required and used?

  Yes

  No

  N/A

• Emergency tow bar on site?

  Yes

  No

  N/A

• Fire Extinguisher available and in date?

  Yes

  No

  N/A

Actions to be entered into CMO:

• Enter an Action, an Action Owner, and an Action Date.
  If N/A, enter “No actions”.

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• 8.

• All actions have been assigned correctly, and Close Calls recorded where required.

  Sign