Title Page
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Site conducted
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Full Name/Team/Contractor:
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Date:
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Prepared by:
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Project Title:
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ELR & Mileage:
Breakdown Details
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Is this OTP?
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Who is the POS provider?
- 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
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Who is the plant Provider?
- 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
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What is the type of plant?
- 360
- Unimog
- Kubota
- Trailer
- Tractor
- Lorry HIAB
- Other Please Specify
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Fleet No
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What is the Fault?
- Host Machine Hydraulic Leak
- Host Machine Hydraulic Failure
- Host Machine Electrical fault
- Host machine Mechanical Fault
- Attachment Mechanical Fault
- Attachment Hydraulic Leak
- Attachment Electrical Fault
- Air System Fault
- Host Machine Safety Fault
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Complete failure of Plant?
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Plant unused?
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Fitter attanded?
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Repaired?
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ALO?
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How Long downtime?
- 30m
- 1HR
- 2HR
- 3HR
- 4HR
- 5HR
- 6HR
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Was recovery Required?
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Did this cause a safety issue?
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Any Further Comments?
Signature
Actions to be entered into CMO:
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Enter an Action, an Action Owner, and an Action Date.
If N/A, enter “No actions”. -
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All actions have been assigned correctly, and Close Calls recorded where required.