Title Page
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Client/Customer
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Site Name
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Contract No
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Conducted on
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Prepared by
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Location
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Purpose of Visit
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Product Type
Site Risk Assesment
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Does site have a COVID-19 Risk Assesment
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Vehicle Access & Egress
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Are site approach roads clear of low bridges
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Is there a designated traffic route allocated by site
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Are there any time restrictions on delivery/collection vehicles
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Is site clear of over head cables
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Is vehicle route to lift area clear of overhanging trees
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Is vehicle route and lifting area clear of underground services and voids
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Is the lifting area clear from water courses and reservoirs
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Is the lifting area clear from Network Rail tracks or airports
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Have site applied for any road closures or parking bay restrictions
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Is there parking onsite for fit out crews and lifting team vehicles
Lift Details
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Site access width
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Site access height
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Ground conditions
- Concrete
- Tarmac
- Crane base (TWD)
- Type 2 Crush
- Trackway
- Other
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Foundation type
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Temporary works designed provided by client for foundations
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Photograph landing Area for cabins
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Maximum Radius of Lift
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Lifting Equipment Required
- Mobile Crane
- Lorry Loader
- Tower Crane
- Fork Lift
- Tracked crane
- other
Project Information
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Site Contact Name
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Site Contact number
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Site Contact Email
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Requested date of installation/collection
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Signed of Drawing available
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How long Site Induction
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PPE Requirements
- Hard Hat
- Chin Strap
- Hi Vis waist coat
- Hi - Vis full length jacket
- Orange trouser
- Safety Glasses
- Safety Boots
- Safety Gloves
- Task Specific
- Other
Customer Information
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Customer Responsibilites