Platinum - EV Charging Removal Report v1.0

• Origin job order number (S-XXXXXXX)

• Site Address
  Address

• Prepared by (Name)

• Company

• Please select the Origin PM for this job (as a notification will be sent to them)

  Select Els Leung Laine Couper Ragav Ranganathan John Mckenzie Kurt Colgar Unknown

  • Els Leung
  • Laine Couper
  • Ragav Ranganathan
  • John Mckenzie
  • Kurt Colgar
  • Unknown

Job safety assessment

• Are there any existing electrical hazards present to conduct the works?

  Yes

  No

• Please elaborate how control measures will be taken

• Any traffic hazards present to conduct the works?

  Yes

  No

• Please elaborate how control measures will be taken

• Will there be any risks to public/pedestrians during the EVC removal works

  Yes

  No

• Please elaborate how control measures will be taken

• Wet weather hazards? (increased risk of slips, trips & falls?)

  Yes

  No

• Please elaborate how control measures will be taken

• Any presence of dangerous animals (i.e. dogs?)

  Yes

  No

• Please elaborate how control measures will be taken

• Presence of any ignition sources?

  Yes

  No

• Please elaborate how control measures will be taken

• Any asbestos or suspicion of asbestos on-site related to the scope of works?

  Yes

  No

• Please elaborate how control measures will be taken

• Potential UV exposure/risk?

  Yes

  No

• Please elaborate how control measures will be taken

• Presence of hazardous substances or dangerous goods?

  Yes

  No

• Please elaborate how control measures will be taken

• Do you have sufficient PPE to conduct the works?

  Yes

  No

• Are there any additional hazards or risks identified on-site? If so, please elaborate

• Total number of team members on-site (including yourself)

• Please confirm that the works that you are conducting can be done safely alone, and confirm that there is a physical person on-site aware of your presence, activity and nature of the works being conducted

  Yes

  No

• Please cease any works until you have consulted your Origin field supervisor for further clarification.

• Upload site specific SWMs applicable for this job

  Media

• I have confirmed that all members of the team are aware of any hazards on-site and have identified appropriate controls and measures for the removal works I also have applicable SWMs on-site & all team members are aware of their role in the safe completion of the work.

  Sign

• Please provide photos of EVC system before removal

  Media

• Is there any existing damage around the EVC location that will not form part of your works to rectify?

  Yes

  No

• Please provide photos of existing damage around EVC location

  Media

• Please confirm you will be removing the EVC and replacing this with a suitably rated general power outlet, at the same location

  Yes

  No

• For EV Charger removals, Origin expects the installer to remove the existing EVC and replace this with a suitably rated GPO at the same location. The GPO is to be fed by the upstream RCBO.
  
  The installer is to ensure that any existing penetrations or any screw holes are to be covered and filled with translucent silicon seal. Unless otherwise agreed to by your Origin PM prior.

• Please advise why you have deviated from the above

• Please confirm that all penetrations and screw holes will be 'made good', covered and sealed appropriately.

  Yes

  No

• Please ensure all penetrations and screw holes are appropriately sealed as this is a requirement of the work order

• Please confirm that the existing upstream RCBO is left untouched, and is supplying power to the installed GPO

  Yes

  No

• Please advise why you have deviated from the above

• Photo of the EVC location after removal, and a replacement GPO installed

  Media

• Photo of any seals/make good of penetrations have been done appropriately

  Media

• Photo of upstream RCBO supplying power to the GPO within customers switchboard

  Media

• Completed Certificate of Electrical safety works

  Media

• Other applicable photos as part of the removal scope of works (please add note)

  Media

• As the installer I have confirmed that I have completed the removal of the EVC in a safe and compliant manner at this address, and have used appropriate seals/coverage on existing penetrations and/or screw holes. I will also take the removed EVC equipment back to my own warehouse and notify Origin to organise pickup after this inspection is completed

  Sign

• Completion date

  Date

• Customer name

• As the customer, I agree all works and the removal of the EVC have been completed to my satisfaction

  Sign