Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
Information
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Location
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JT No
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Details of Operation
Numbers of Staff on Site
Plant and Equipment in use
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Chainsaws
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Hedge Trimmer
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Strimmers
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Pole Saw
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Disc Saw
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Generator
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Rock Drill
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Spanex Guns
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Compressors
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Hand Drill
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Grout Pump
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Other
DOCUMENTATION
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WPP/TBS/Method Statement
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Risk Assessments & COSHH Assessments
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Vibration Assessments
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IRATA Tool Box Talk (QTS/F/101)
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IRATA Daily Log (QTS/F/100)
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Records of Trigger Times
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Instructions for Equipment
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Unique Rescue Plan
Site Staff
L3 Supervisor
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Name
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Expiry Date of L3 Certificate
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Expiry Date of First Aid Certificate
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Sentinel Card Number
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Expiry Date
Log Book
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Date of Last Entry
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Signatures of Supervisors
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Hours on Ropes Detailed
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Details of Tasks
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Comments
Technician
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Name
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Level
- Level 1
- Level 2
- Level 3
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Expiry Date
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Sentinel Card Number
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Expiry Date
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Competences
- NPTC
- Abrasive Wheels
- Other
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Expiry Date
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Competences
- NPTC
- Abrasive Wheels
- Other
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Expiry Date
Log Book
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Date of Last Entry
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Signatures of Supervisors
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Hours on Ropes Detailed
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Details of Tasks
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Comments
Technician
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Name
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Level
- Level 1
- Level 2
- Level 3
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Expiry Date
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Sentinel Card Number
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Expiry Date
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Competences
- NPTC
- Abrasive Wheels
- Other
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Expiry Date
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Competences
- NPTC
- Abrasive Wheels
- Other
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Expiry Date
Log Book
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Date of Last Entry
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Signatures of Supervisors
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Hours on Ropes Detailed
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Details of Tasks
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Comments
Technician
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Name
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Level
- Level 1
- Level 2
- Level 3
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Expiry Date
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Sentinel Card Number
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Expiry Date
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Competences
- NPTC
- Abrasive Wheels
- Other
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Expiry Date
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Competences
- NPTC
- Abrasive Wheels
- Other
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Expiry Date
Log Book
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Date of Last Entry
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Signatures of Supervisors
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Hours on Ropes Detailed
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Details of Tasks
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Comments
PPE
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Helmets
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Gloves
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Dust Masks
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Visor
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Safety Glasses
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Hi Viz
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Waterproofs
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Safety Boots
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Ear Defenders/Plugs
Plant and Equipment
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Item
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Asset Number
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Service Record /Label
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Condition
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Signage
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Thorough Examination
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Expiry Date
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Guards
Plant and Equipment
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Item
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Asset Number
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Service Record /Label
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Condition
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Signage
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Thorough Examination
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Expiry Date
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Guards
Plant and Equipment
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Item
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Asset Number
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Service Record /Label
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Condition
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Signage
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Thorough Examination
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Expiry Date
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Guards
Plant and Equipment
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Item
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Asset Number
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Service Record /Label
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Condition
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Signage
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Thorough Examination
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Expiry Date
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Guards
Rope Access Equipment
Certificate of Thorough Examination
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Certificate No
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Expiry Date
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Name of Examiner
Rope Access Equipment in Use
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Item
- Karabiner
- Croll
- Stop
- Shunt
- Duck
- Ascender
- Harness
- Rope
- Cowtail
- Rescue Kit
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Reference No
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On certificate
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Item
- Karabiner
- Croll
- Stop
- Shunt
- Duck
- Ascender
- Harness
- Rope
- Cowtail
- Rescue Kit
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Reference No
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On certificate
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Item
- Karabiner
- Croll
- Stop
- Shunt
- Duck
- Ascender
- Harness
- Rope
- Cowtail
- Rescue Kit
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Reference No
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On certificate
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Item
- Karabiner
- Croll
- Stop
- Shunt
- Duck
- Ascender
- Harness
- Rope
- Cowtail
- Rescue Kit
-
Reference No
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On certificate
-
Item
- Karabiner
- Croll
- Stop
- Shunt
- Duck
- Ascender
- Harness
- Rope
- Cowtail
- Rescue Kit
-
Reference No
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On certificate
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Item
- Karabiner
- Croll
- Stop
- Shunt
- Duck
- Ascender
- Harness
- Rope
- Cowtail
- Rescue Kit
-
Reference No
-
On certificate
-
Item
- Karabiner
- Croll
- Stop
- Shunt
- Duck
- Ascender
- Harness
- Rope
- Cowtail
- Rescue Kit
-
Reference No
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On certificate
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Item
- Karabiner
- Croll
- Stop
- Shunt
- Duck
- Ascender
- Harness
- Rope
- Cowtail
- Rescue Kit
-
Reference No
-
On certificate
-
Item
- Karabiner
- Croll
- Stop
- Shunt
- Duck
- Ascender
- Harness
- Rope
- Cowtail
- Rescue Kit
-
Reference No
-
On certificate
-
Item
- Karabiner
- Croll
- Stop
- Shunt
- Duck
- Ascender
- Harness
- Rope
- Cowtail
- Rescue Kit
-
Reference No
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On certificate
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Item
- Karabiner
- Croll
- Stop
- Shunt
- Duck
- Ascender
- Harness
- Rope
- Cowtail
- Rescue Kit
-
Reference No
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On certificate
-
Item
- Karabiner
- Croll
- Stop
- Shunt
- Duck
- Ascender
- Harness
- Rope
- Cowtail
- Rescue Kit
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Reference No
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On certificate
General Operations
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Use of Rope Access
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Operating Tools
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Operators secured by 2 ropes
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Hand tools secured by lanyards
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Anchor Point Protection
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Rescue Plan Practiced
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General Operation
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Finished Quality
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Welfare
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Lighting
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Traffic Management
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First Aid Kit
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Fire Extinguisher
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Spill Kit
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Rescue Kit
Auditor
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Auditor
I confirm the above actions have completed
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Name
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Signature