PIA - Brightr

• OPP

• Work Order #

• Email Address

  office@clevenelectrical.co.nz

• Installers on site

• Are there site hazards?

  Yes

  No

  N/A

• If yes, Please record the description of the hazard from the list below: -Loose dog(s) on Site -Unsupervised Children -Dead/Decaying Animals -Stored Chemicals -Narrow Driveway -Unsafe Parking -Access Level (trip hazards) -Wasps or Bees -Broken Glass -Rusty Nails or Metal -Height (Safe for Ladders) -Asbestos on site -Rubbish on site, Please add how much -Other Hazard

• If there is a site hazard, have you ensured that all identified risks to health and safety have been eliminated or otherwise minimized appropriately before commencing the installation assessment?

  Yes

  No

  N/A

• If there is a site hazard, have you reviewed and understood the Site-specific Health and Safety Assessment and the controls implemented to manage identified risks?

  Yes

  No

  N/A

• If there is a site hazard, Did you inform the owner of any site specific hazards that you found may affect them?

  Yes

  No

  N/A

Part 2 - Electrical Hazards and Issues

• Old or Brittle Cabling?

  Yes

  No

  N/A

• Please provide details

• Other Electrical Hazard?

  Yes

  No

  N/A

• Please provide details

• Any electrical issue that will prevent installation?

  Yes

  No

  N/A

• Please provide details

Part 3 - Pre-existing Damage to Property

• Any existing damage to walls, floors, floor coverings, ceilings, doors, windows or drapes at area of install indoors?

  Yes

  No

  N/A

• Please provide description

• Please add photo

  Media

• Any existing damage to external walls, soffit, roof, deck paving at area of install outdoors?

  Yes

  No

  N/A

• Please provide description

• Please add photo

  Media

• Any existing damage to ceiling, insulation, trapdoor, cabling at area of install in ceiling space?

  Yes

  No

  N/A

• Please provide description

• Please add photo

  Media

Technician / Van Leader to sign

• Name

• Date

  Date

• Signature

  Sign