Information
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Job number:
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Prepared by & job role:
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Conducted on
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Who else is on site?
- Lead Engineer
- SE's
- Engineers
- Other e.g. First Aider
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Premises Contact name & number:
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Additional address or parking information: (if required)
Job type?
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New install or upgrade
A: Access to place of work. Note any specific work equipment required to gain access to the work area/position.
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- Ladders
- Scaffold
- Walk way
- MEWP
- Stairway
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Give brief details of how safe access will be controlled and maintained to reduce the likelihood of an incident occurring, to include 3rd parties:
B: Work area security:
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- Fixed Barrier
- Notices
- Warning Tape
- 2nd Man
- Other
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Give brief details of how work place security will be maintained to reduce the likelihood of an incident occurring, to include 3rd parties:
C: COSHH
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- Flammables
- Harmful
- Explosives
- Radiation
- Toxic
- Fumes/vapours
- Corrosive
- Dust
- Irritant
- Other
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Give brief details of any hazardous substances to be used on site and precautions taken to ensure safety of workers and others that might be affected by their actions:
D: Asbestos
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Surveyor must examine the asbestos register to identify if asbestos containing materials (ACMs) are present anywhere in the work area, and detail the control measures that are required if ACMs are identified. Details-
E: Safe Systems of Work, communication & equipment.
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- Two way radio
- Mobile phone
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Safety Notes - ensure all radios are on the same frequency and that it does not interfere with other uses e.g. Emergency services. Details if applicable-
F: Onsite traffic routes for equipment movement. Have the following floor conditions been assessed?
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- Strength to support loads
- Slips
- Trips
- Falls
- Obstructions
- Visibilty
- Hazard signs
- Segregation of vehicles & pedestrians
- Parking
- Speed limits
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Define specific safety routes & control measures for either - vehicular movement or pedestrians.
G: Personal protective equipment, relevant PPE is to be worn at all times.
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The following list of company issued equipment is the minimum of what is expected for the Engineers to wear relating to an activity. Not excluding what control measures are in place after the dynamic risk assessment is completed, which could change the list: A) Work area general - Hardhat, Safety footwear, gloves & uniform B) Work at Height - in addition to the above; Harness and fall arrest equipment C) Drilling activities - in addition to the above; goggles, masks, hearing protection Any additional PPE required and specific reasons for its use are to be listed below:
H: Training & Instructions What training and instruction is required for employees to carry out the work safely:
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All Sky - HS&S staff are to be fully aware of the work area and activities taking place. All HS&S staff are trained in the activity to be carried out. A full list is available on request. If there is a property management/security briefing from the customers representatives they shall adhere to their guidelines at all times. If no briefing is given the Lead Engineer will deliver a briefing on the work area, work activity to be carried out and any other control measures in place, found on the dynamic risk assessment. Additional information if applicable:
I: Supervision, Lead Engineer. Detail the level of supervision to be provided and describe their responsibilities with regard to monitoring the safe working activities ( including 3rd parties)
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The "Lead Engineer" is the Engineer who has been issued the job and is responsible for the following, but not limited to - - Carrying out the dynamic risk assessment - Communicating the findings of the risk assessment to all Engineers and third parties if required - Ensure the method of working is carried out in a safe and timely manner - Ensure the work area is left in a tidy state, all waste is to be removed and disposed of accordingly Additional information if applicable:
J: Local information & Safety notes
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Local Fire plan: in accordance with the site owners procedures Local briefing: Task brief given to commencement of the task by team Lead Engineer Welfare arrangements: if available and authorised use of facilities on site Emergency & Rescue procedures In the event of an incident occurring the following actions should be taken, this is in addition to the Commercial premises emergency plan: Any additional information if applicable: 1) Verbal and visual communication. Shout the casualties name to gain their attention and gauge response. Get into a position where the casualty may be observed. 2) Contact emergency services. Call 999 or 112, ensure that if rescue from height is required the emergency services are informed and the situation accurately described. 3) Assist emergency services. Once emergency services are on site, assist as required under their guidance 4) inform Team Manager. It is essential that the Team Manager is informed of the situation and allow the accident management procedure to be followed Post incident - Report all incidents and accidents in accordance with BskyB Accident and Incident reporting procedures Add any additional information if required:
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On completion of the task - The Engineers will - - Remove all work equipment - tools etc - Carry out an " after use" inspection of all equipment used and store in appropriate bags - Carry out site audit - Clear and tidy site, remove all waste and dispose of accordingly - Remove all warning and caution signs previously installed Add any additional information if required:
K: All work activities are to be carried out in accordance with the main HS&S current procedures listed below, but not limited to
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- Working on Ladders - Manual Handling - Access to and from work - Risk Assessment process - PPE - Drilling procedures Add any additional info if applicable:
L: Work plan/ Method Statement. The categories below must be used to detail all works to be carried out. Breakdown of the work activity & the safety precautions to be taken at each stage. Use Skitch to clearly identify all cable/ entry routes.
Equipment currently on site?
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Detail existing equipment & location:
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Pictures of existing equipment:
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Current Wifi coverage area if applicable?
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Areas to be covered:
Overview of work to be carried out
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Please provide an overview of work to be carried out:
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Add wide angle photos of all areas that require coverage.
Router or Dish location
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Add any other hazard/risk associated with this activity or work area. Include the appropriate control measures to be out in place.
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Detail where router/dish is to be installed:
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Is the router a CISCO or SAGEM
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Photos of router/dish location & cable routes. Use Skitch to show cable routes
Switch or STB location
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Add any other hazard/risk associated with this activity or work area. Include the appropriate control measures to be out in place.
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Detail where switch/STB is to be installed:
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Cable run length from router/dish?
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Photo of switch/TV location
Access Point 1 or TV 1
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Add any other hazard/risk associated with this activity or work area. Include the appropriate control measures to be out in place.
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Cable run length from switch or TV?
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AP1 or TV cable route. Use Skitch to show cable routes
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Access point 1 or TV mounting type<br><br><br>
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POE Injector required
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Wifi scan of AP in this location
Access Point 2 or TV 2 if applicable
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Add any other hazard/risk associated with this activity or work area. Include the appropriate control measures to be out in place.
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Cable run length from switch or STB if applicable?
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AP2 or TV cable routes. Use Skitch to show cable routes, if applicable?
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Access point 2 or TV mounting type<br>
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POE Injector required
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Wifi scan of AP in this location
Access Point 3 or TV 3 if applicable
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Add any other hazard/risk associated with this activity or work area. Include the appropriate control measures to be out in place.
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Cable run length from switch or STB if applicable?
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AP3 or TV cable routes. Use Skitch to show cable routes if applicable?
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Access point 3 or TV mounting type<br>
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POE Injector required
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Wifi scan of AP in this location
Access Point 4 or TV 4 if applicable
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Add any other hazard/risk associated with this activity or work area. Include the appropriate control measures to be out in place.
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Cable run length from switch or STB if applicable?
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AP4 or TV cable routes. Use Skitch to show cable routes if applicable?
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Access point 4 or TV mounting type<br>
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POE Injector required
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Wifi scan of AP in this location
Access Point 5 or TV 5 if applicable
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Add any other hazard/risk associated with this activity or work area. Include the appropriate control measures to be out in place.
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Cable run length from switch or STB if applicable?
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AP5 or TV 5 cable routes. Use Skitch to show cable routes if applicable?
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Access point 5 or TV mounting type<br>
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POE Injector required
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Wifi scan of AP in this location
Additional information:
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Are there any areas that will not be covered by AP's?
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Existing WIFI networks detail:
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Estimated install time and any parking information, including costs:
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Any additional information e.g. Conduit required, availability of power and any other information identified or needed to be escalated.
Job Summary
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Select the following responses<br><br>Green <br>The job can continue with a new job booked with the correct time allocated<br>There are no extra items of equipment and no escalation is required <br><br><br>Amber <br>The job cannot continue without any extra equipment being ordered to complete the job<br>The job cannot continue as Extra safety equipment is required to complete the job<br>Any other reason where we can complete the job but authorisation will be required. <br><br>Red<br>The job has been surveyed and there are no possible cable routes available<br>The job cannot be completed using HS&S safety practises<br>(JDW has a property team who can assess the work required if above HS&S safety practises)
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If Amber or Red please supply a summary of the reasons.
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If additional items are required, please list here for ordering purposes
