Information

  • Visit Number

  • Conducted on

  • Name of commercial premises/ shopping centre

  • Premises contact name: Email address: Telephone :

  • BSKYB surveyor: Contact Number: Email address:

  • SRS contact. Email address:

  • Predicted install date:

  • Manpower:

  • Equipment required:

  • Location

Brief description of work to be undertaken:

Access to place of work

  • Scaffold

  • Ladders

  • Walkway

  • Crane

  • Mobile lift

  • Stairway

  • Folk lift

  • Other

  • Give brief details of how safe access will be maintained

Workplace area security

  • Fixed Barrier

  • Notices

  • Warning Tape

  • 2nd Man

  • Other

  • Give brief details of how safe access will be maintained

COSHH

  • Flammables

  • Explosives

  • Toxic

  • Corrosive

  • Irritant

  • Harmful

  • Radiation

  • Fumes/vapours

  • Asbestos

  • Others

  • Give brief details of hazardous substances to be used on site and precautions taken to ensure safety of workers and others that might be affected by there actions:

Power sources and isolation

  • Electrical

  • Hydraulic

  • Pneumatic

  • Internally stored

  • Chemical

  • Chemical supply

  • Compressed air

  • Other

  • Give brief details of any hazards on site and precautions taken to ensure safety of workers and others.

Co-ordination of activities Method Statement

  • VIP Lead Engineer

  • VIP Enginner

  • SE Engineer

  • 3rd Party

  • Other

  • FULL METHOD STATEMENT: describe the role of your working party supervisor and methods of safe co-ordination used

Safe systems of work: Communication equipment

  • Wilkie- Talkie

  • Mobile phone

  • Verbal

  • Safety notes

When in public areas full attention will be paid by 2nd man to ensure full public and engineer safety at all times,to ensure all tools and equipment are secured against falling.

On site traffic routes for equipment movement : Have the following floor condition been assessed ?

  • Strength to support loads

  • Slips

  • Trips

  • Falls

  • Obstructions

  • Segregation of vehicle and pedestrian

  • Hazard signs

  • Speed limits

  • Visibility

  • Other

Housekeeping

  • Safe storage of materials/equipment

  • Removal of waste/surplus materials

  • Safe storage of flammables

  • Safe disposal of all waste

  • All waste will be classed as inert and disposed of accordingly All equipment will be taken off site

Personal protective equipment

  • PPE

  • Fall arrest equipment

  • Goggles

  • Gloves

  • Boots

  • Other

  • Detail level of PPE required and specific reasons for its use,PPE to be used at all times

Training and instruction- What training and instruction is required for your employees to carry out the work safely.

  • Induction by contract supervisor

  • Environment awareness training

  • Site hazards

  • Hazards specific to job

  • Equipment training

  • Evacuation training

  • IPAF operation certificate

Supervision

  • Detail the level of supervision to be provided and describe their responsibilities with regard to monitoring the safe working activities (inc 3rd parties)

Monitor and review details how this will be monitored and reviewed on completion of job

Local information and safety notes:

LOCAL FIRE PLAN: in accordance with the site owners procedures LOCAL BRIEFING: Task brief given prior to commencement of the task by Lead engineer WELFARE ARRANGEMENTS: If available and authorised use of facilities on site.

Emergency and rescue procedures

  • In the event of an incident occurring the following actions should be taken,this is addition to the commercial premises emergency plan. Call the appropriate emergency services and ensure they are briefed of the situation and exact location of the incident. IF WORK AT HEIGHT: If there is a requirement to rescue from height this must be carried out by the Lead engineer,supported by other engineers,and carried out in accordance with the training received and instructions given. TEAM FIRST AID MEMBERS: All employees are trained in first aid and emergency procedures. POST INCIDENT: Report all incidents and accidents in accordance with BSKYB accident and incident reporting procedures.

ON COMPLETION OF THE TASK: the engineers will- - Remove all equipment. - Carry out an ' after use inspection of all equipment used and store in appropriate ways. - Carry out a site walk round with all engineers and if possible centre Managemnt team. - Clear and tidy site. - Remove all warning and caution signs previously installed.

  • Any other items required for the task:

Supporting Images

  • Add media

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.