Roofing - PPM Survey

• Form type:

  PPM Survey

  Gutter Clean

• Attendance Date:

  Date

• Client:

  M&S

  Pets at Home

  Morrisons

  Other

Store Details

• Store Name:

• Store Number:

• Location:
  Address

Project Number(s)

• Client Project Number:

• Key Project Number:

Operatives

• Primary Roofing Operative (Full Name):

• Secondary Roofing Operative (Full Name):

Health & Safety Checklist

• Is a permit or third party authorisation required to access to the roof?

  Yes

  No

• Is a permit or written authorisation in place?

  Yes

  No

• Do not access the roof

• Provide contact details for permit / authorisation to be obtained (Name, Email Address, Contact Number, Documents Required)

• Is the asbestos register available?

  Yes

  No

• Review asbestos register

• Has the RAAC registers been checked?

  Yes

  No

  N/A

• Can the roof be accessed safely?

  Yes

  No

• If the roof cannot be accessed what further measures are required?

• Is temporary fall protection required and available?

  Yes

  No

• What fall protection is in place?

  Select Parapet Wall(s) Wall(s) Fence(s) Handrail Roof Rail Safety Line None Present

  • Parapet Wall(s)
  • Wall(s)
  • Fence(s)
  • Handrail
  • Roof Rail
  • Safety Line
  • None Present

• Is the safety line inspection tag in place and in date?

  Yes

  No

• Do not use the safety line

• Is temporary fall protection required and available?

  Yes

  No

• Is a harness and lanyard required and are they available?

  Yes

  No

• Is a MEWP required to carry out the work?

  Yes

  No

• Are MEWP operators IPAF trained?

  Yes

  No

• Are there any fragile surfaces?

  Yes

  No

• What precautions to prevent falls are in place?

• Do the weather conditions fall within limits stated in RAMS?

  Yes

  No

• Have all operatives been briefed on the RAMS?

  Yes

  No

• Can materials be taken to the roof safely?

  Yes

  No

• Is all waste removed from the roof?

  Yes

  No

• Form Type:

  PPM Survey

  Gutter Clean

• Photograph of the front of the store

  Media

• Has drone footage been captured of the roof

  Yes

  No

• Please advise why footage could not be captured

General

Building Details

• Estimated build date (Leave blank if unknown)

  Date

• Is the property over 20 years old

  Yes

  No

  Unknown

• Roof ownership

  Freehold

  Leasehold

  Unknown

• Is a roof register present

  Yes

  No

• Is the roof register being actively used

  Yes

  No

• Type of access used to access the roof

  Select Van mounted MEWP External Staircase Internal Staircase Roof Hatch Cat Ladder Ship Ladder Maintenance door (Level access) Lift MEWP access

  • Van mounted MEWP
  • External Staircase
  • Internal Staircase
  • Roof Hatch
  • Cat Ladder
  • Ship Ladder
  • Maintenance door (Level access)
  • Lift
  • MEWP access

• Ensure segregation is utilised to protect the public and / or store colleagues

• Are roof lights or fragile surfaces present

  Yes

  No

• Can operatives undertake the works at hand whilst maintaining a safe working distance from the fragile surfaces?

  Yes

  No

• Ensure safe working distance from any fragile surfaces at all times

• Do not access the roof

• Client store representative who has confirmed authorisation to access the roof

  Sign

• Are there any defined walkways

  Yes

  No

Roof Construction

• Roof construction materials

  Select Asphalt Coated Composite Panels Concrete EDPM EPF Membrane Fibreglass Coating Flags Foam Insulation Boards Pebbles Plywood lined Rubber Slabs Slate / Tiles Solar paint Standing seam sheets Steel Sheeting

  • Asphalt
  • Coated
  • Composite Panels
  • Concrete
  • EDPM
  • EPF Membrane
  • Fibreglass Coating
  • Flags
  • Foam Insulation Boards
  • Pebbles
  • Plywood lined
  • Rubber
  • Slabs
  • Slate / Tiles
  • Solar paint
  • Standing seam sheets
  • Steel Sheeting

• Other roof materials

  Select Asphalt Coated Composite Panels Concrete EDPM EPF Membrane Fibreglass Coating Flags Foam Insulation Boards Pebbles Plywood lined Rubber Slabs Slate / Tiles Solar paint Standing seam sheets Steel Sheeting

  • Asphalt
  • Coated
  • Composite Panels
  • Concrete
  • EDPM
  • EPF Membrane
  • Fibreglass Coating
  • Flags
  • Foam Insulation Boards
  • Pebbles
  • Plywood lined
  • Rubber
  • Slabs
  • Slate / Tiles
  • Solar paint
  • Standing seam sheets
  • Steel Sheeting

• Gutter type

  Gravity

  Siphonic

  Mixture

• Are outlet covers present

  Yes

  No

• Are there any overflow outlets present on the roof

  Yes

  No

Works undertaken

• Photographs of roof and gutters conditions prior to clean

  Media

• Photographs of roof and gutters conditions after to clean

  Media

• Full description of works carried out

• Are all gutters (valley & trough) clear

  Yes

  No

• Have all leaf guards / hoppers been cleaned and cleared of debris?

  Yes

  No

Roof Condition

• Is there any cut edge corrosion present to any roof sheets?

  Yes

  No

• Is there any damage to any capping details?

  Yes

  No

• Is there any damage to any flashing details?

  Yes

  No

• Notes on existing coursework pointing

• Are there any related issues that are deemed essential and may compromise store trading?

  Yes

  No

• Description of issues deemed essential and / or may compromise store trading

• Please complete a separate survey template capturing as much detail as possible

• Are there any roof leaks reported by the store

  Yes

  No

• Where are the reported leaks within the store

• Provide annotated google screenshot showing the leak locations

  Drawing

• Is there any debris discarded on the roof

  Yes

  No

• Are there any apparent pest issues (For example bird activity)

  Yes

  No

• Are there any poor installs with regards to plant and the interface with the roof

  Yes

  No

• Is there evidence of recent works to the roof

  Yes

  No

• Are you aware if the recent works carries a valid warranty

  Yes

  No

• Overall condition of roof (1 = Poor; 5 = Excellent)

• Photograph of the front of the store

  Media

• Type of access used to access the roof

  Select Van mounted MEWP External Staircase Internal Staircase Roof Hatch Cat Ladder Ship Ladder Maintenance door (Level access) Lift MEWP access

  • Van mounted MEWP
  • External Staircase
  • Internal Staircase
  • Roof Hatch
  • Cat Ladder
  • Ship Ladder
  • Maintenance door (Level access)
  • Lift
  • MEWP access

• Ensure segregation is utilised to protect the public and / or store colleagues

• Are roof lights or fragile surfaces present

  Yes

  No

• Can operatives undertake the works at hand whilst maintaining a safe working distance from the fragile surfaces? (2 meters)

  Yes

  No

• Ensure safe working distance from any fragile surfaces at all times

• Do not access the roof

• Client store representative who has confirmed authorisation to access the roof

  Sign

• Roof construction materials

  Select Asphalt Coated Composite Panels Concrete EDPM EPF Membrane Fibreglass Coating Flags Foam Insulation Boards Pebbles Plywood lined Rubber Slabs Slate / Tiles Solar paint Standing seam sheets Steel Sheeting

  • Asphalt
  • Coated
  • Composite Panels
  • Concrete
  • EDPM
  • EPF Membrane
  • Fibreglass Coating
  • Flags
  • Foam Insulation Boards
  • Pebbles
  • Plywood lined
  • Rubber
  • Slabs
  • Slate / Tiles
  • Solar paint
  • Standing seam sheets
  • Steel Sheeting

• Gutter type

  Gravity

  Siphonic

  Mixture

• Are outlet covers present

  Yes

  No

• Photographs of gutter conditions prior to clean

  Media

• Photographs of gutter conditions after to clean

  Media

• Have all leaf guards / hoppers been cleaned and cleared of debris?

  Yes

  No

• Full description of works carried out

• Are there any overflow outlets present on the roof

  Yes

  No

• Is there any cut edge corrosion present to any roof sheets?

  Yes

  No

• Is there any damage to any capping or flashing details?

  Yes

  No

Checklist

• Works completed

  Yes

  No

• Photographs taken

  Yes

  No

• Test certificates

  Yes

  No

• Install complete

  Yes

  No

• Works signed-off

  Yes

  No

Work Times

• Travel Time (Hours)

  Select 1 2 3 4 5 6 7 8 9 10

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10

• Time on site

  Date

• Time off site

  Date

Works Undertaken

• Description of works carried out

• Material used

• Plant used

• Is additional works required

  Yes

  No

• In-depth description of additional works required:

• Please complete additional survey template to capture the in-depth additional works required

Signatures

• Store representative

  Sign

• Key representative

  Sign