Premier Metal Fabrications Risk Assessment & Method Statement (Pre-Start Survey) V2.0

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• THIS SURVEY IS TO BE COMPLETED BEFORE THE HEALTH & SAFETY SITE FOLDER IS CREATED FOR LARGER PROJECTS.
  
  THIS SURVEY MUST BE USED TO HELP COMPILE AN ACCURATE AND DETAILED SITE HEALTH & SAFETY FOLDER.
  
  THIS SURVEY IS TO BE SITE SPECIFIC AND MUST BE COMPLETED ON SITE PRIOR TO ATTEMPTING THE CREATION OF THE HEALTH & SAFETY FOLDER.
  
  THIS SURVEY IS TO BE ADDED TO THE HEALTH & SAFETY FOLDER.
  
  

INSTALLATION DETAILS

• Assessment Carried Out By:

  Ashley Chown

  Ian Bowler

  Carl Revees

  Paul Hulin

• Date:

  Date
• Site Location:
  Address

• Description of Works to be Carried Out:

RISK ASSESSMENT

• REFER TO THE LIST BELOW SELECTING THE AREAS WHICH MAY BE A RISK.
  
  ONCE A SELECTION HAS BEEN MADE YOU MUST WRITE IN DETAIL THE POTENTIAL RISKS ASSOCIATED WITH THE ITEM SELECTED.

• RA001 - Asbestos

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA002 - Brick / Block Work

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA003 - Cartridge Operated Fixing Tools

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA004 - Confined Spaces

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA005 - Demolition

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA006 - Driving at Work

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA007 - Dust & Fumes

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA008 - Excavations

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA009 - Excavators

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA010 - Falling Objects

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA011 - Fire & Explosion

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA012 - Fork Lift Trucks

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA013 - Fragile Roofs

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA014 - Gin Wheels

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA015 - Hand Tools

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA016 - Working at Heights

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA017 - Highways

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA018 - Hot Works

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA019 - Industrial Roofs

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA020 - Violent / Dangerous Occupants

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA021 - Ladders

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• WARNING - CERTAIN SITES WILL NOT ALLOW WORKING AT HEIGHTS VIA LADDERS.
  
  CONFORM WITH THE CLIENT IF LADDERS ARE ACCEPTABLE.
  
  MAKE CONSIDERATIONS FOR TRAINING AND HARNESS'S.
  
  

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA022 - Lifting Gear

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA023 - Lone Working

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA024 - LPG

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA025 - Machinery

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA026 - Manual Handling

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA027 - Mobile Elevated Platform Works

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA028 - Mobile Cranes

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA029 - Mobile Masts

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA030 - Mobile Plant

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA031 - Noise at Work

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA032 - Openings

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA033 - Overhead Power Lines

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA034 - Breaking into Pipelines

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA035 - Pneumatic Tools

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA036 - Portable Electric Appliances

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA037 - Public On-Site

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA038 - Site Staff

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA039 - Scaffolding

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA040 - Sharpe Edges, Nails etc.

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA041 - Slips Trips & Falls

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA042 - Vulnerable Persons

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA043 - Step Ladders

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• WARNING - CERTAIN SITES DO NOT ALLOW USE OF STEP LADDERS.
  
  IF THIS IS THE CASE HOP-UPS MUST BE USED.

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA044 - Tower Cranes

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA045 - Tower Scaffolds

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• WARNING - IT IS A MANDATORY REQUIREMENT THAT ONLY PERSONNEL WITH PASMA TRAINING WORKS WITH TOWER SCAFFOLDING.
  
  IT IS ACCEPTABLE FOR THE TOWER TO BE ERECTED BY A PASMA TRAINED OPERATIVE FOR OTHERS TO USE.

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA046 - Underground Services

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA047 - Vibration

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA048 - Core Cutting

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA049 - Young Persons

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• WARNING - AUTHORISATION IS REQUIRED BY THE PARENT OR GUARDIAN IN WRITING CONFIRMING THE INDIVIDUAL HAS PERMISSION TO ATTEND SITE.
  
  A COPY OF THE LETTER IS TO BE INSERTED INTO THE SITE HEALTH & SAFETY FOLDER AND EMAILED DIRECT TO THE CLIENT.

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

• RA050 - Electricity

  YES

  NO

• Level of risk ( 1 - low, 5 - high)

  1

  2

  3

  4

  5

• Detail the Risk(s) Identified:

• Give Detail of how to Limit, Reduce or Remove the Risk:

• If the Above Restrictions are in place Is it Safe to Proceed?

  SAFE

  DO NO PROCEED

METHOD STATEMENT

• Company Name

• Project title

• Add location
  Address

• Contact No.

• Method Statement title

• Reference

• Description of work

• This method statement has been developed and must be read with the following risk assessment

• Work commences on

• Select date

  Date

• Areas to be worked in

• Actual or estimated duration of works (hours)

• Actual or estimated number of workers

• Personnel (include details of all personnel involved in the task and any specific training, skills or qualifications required)

• Personnel

  Select Ashley chown - Primary site supervisor - SMSTS, banks man/slinger Ian Bowler - Secondary site supervisor - PASMA, IPAF Richard Taylor - Site worker - CSCS

  • Ashley chown - Primary site supervisor - SMSTS, banks man/slinger
  • Ian Bowler - Secondary site supervisor - PASMA, IPAF
  • Richard Taylor - Site worker - CSCS

• Emergency arrangement details

• Fire/evacuation

• First aid

• Pollution/spill

• Other

• Personal protective equipment (PPE) requirements

• Head (EN 397)

• Foot (BS EN 345-1)

• Hi-vis vest

• Hand (BS EN 388)

• Eye (EN 166)

• Hearing (EN 352-1)

• Fall arrest

• Other

• Construction dust (note: construction dust is harmful and can lead to fatal lung diseases such as silicosis)

• Will the work create dust or fumes

  YES

  NO

• Identify specific control measures to avoid or minimise dust or fumes

• Identify respiratory protective equipment (RPE) that will be required if dust or fumes cannot be avoided

• Hazardous materials

• Are hazardous materials to be used

  YES

  NO

• Are COSHH/DSEAR data sheets available

  YES

  NO

• Attach or identify specific controls required from COSHH risk assesment

• Permits required

  Select Permit to work (general) Permit to enter (confined spaces) Permit to dig Hot work permit Out of hours work permit

  • Permit to work (general)
  • Permit to enter (confined spaces)
  • Permit to dig
  • Hot work permit
  • Out of hours work permit

• Other

• Details of person issuing permit

• A DETAILED DESCRIPTION OF HOW THE WORKS ARE TO BE COMPLETED MUST BE NOTED BELOW.

• Detailed Description of Method Statement:

• Tools, plant and equipment

• Specify type including details of inspection/test certificates

• A copy of this briefing register must be attached to the method statement, together with other relevant information ( such as the associated risk assessments, permits or COSHH assessments)

• Supervisor in charge of works

• Name

  Ashley Chown

  Ian Bowler

  Carl Revees

  Paul Hulin

• Position

  Managing director

  Production Manager

  Site Manager

  Site Supervisor

• Add signature

  Sign

• Select date

  Date

• ALL OPERATIVES TO SIGN ACKNOWLEDGEMENT PAGE

COSHH

• SELECT FROM THE LIST BELOW SELECTING THE AREAS WHICH MAY BE A RISK:

• Silicon Based Products to be Used?

  YES

  N/A

• INSERT THE COSHH REPORT INTO THE HEALTH & SAFETY SITE FOLDER.

• Will Dust be Present or Created by these Works?

  YES

  N/A

• INSERT THE COSHH REPORT INTO THE HEALTH & SAFETY SITE FOLDER.

• Will there be a Requirement to Use Expanding Foam?

  YES

  N/A

• INSERT THE COSHH REPORT INTO THE HEALTH & SAFETY SITE FOLDER.

• Please List any Other Hazardous Substance:

SPECIAL REQUIREMENTS

• PLEASE DETAIL ANY SPECIAL REQUEST FROM THE CLIENT OR WHICH MAY BE A REQUIREMENT TO COMPLETE THIS PARTICULAR PROJECT

• Please Detail any Special Requirements:

POINTS TO REMEMBER

• All Personnel have the Correct CSCS Card?

  EVIDENCE @ HEAD OFFICE

  CONFIRMATION REQUIRED

  EVIDENCE REQUIRED

  REQUIRES ARRANGING

• All Personnel have a UKATA Asbestos Training Certificate?

  EVIDENCE @ HEAD OFFICE

  CONFIRMATION REQUIRED

  EVIDENCE REQUIRED

  REQUIRES ARRANGING

• A Plant Register has been created for the RAMS File?

  EVIDENCE @ HEAD OFFICE

  CONFIRMATION REQUIRED

  EVIDENCE REQUIRED

  REQUIRES ARRANGING

• PAT Testing of All Electrical Equipment has either been Completed prior to starting or a date has been arranged?

  EVIDENCE @ HEAD OFFICE

  CONFIRMATION REQUIRED

  EVIDENCE REQUIRED

  REQUIRES ARRANGING

COMPLETED BY:

• Print & Sign

  Sign

• PLEASE INCLUDE THIS REPORT AS PART OF THE HEALTH & SAFETY SITE FOLDER.