Roofing - Safety Line Inspection Sheet

• Form Type:

  Safety Line Form

• 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

• Does the safety line have an in date Inspection Tag

  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

• Make / Manufacturer

• Date of last inspection

  Date

• Photograph of Inspection Tag

  Media

Condition

Base Plates

• Quantity

• Max kg

• General comments on the overall condition

Safety Line

• General comments on the overall condition

• Pass or Fail (If pass, photograph of new inspection tag)

  Pass

  Fail

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:

Signatures

• Store representative

  Sign

• Key representative

  Sign