S S Report

• Site conducted

  Select

• Document No.

• Audit Title

• Client / Site

• Prepared by

  DB

• Date Completed

  Date
• Location
  Address

Customer and Site Information

• Company or Organisation Name

• Customer Contact Name

• Customer Contact Number

• Customer E-mail Address

• Site Contact Name

• Site Contact Number

• Site Address (Exact Location Given)
  Address

Site Details - Machine Requirements and Set Up Information

• Height restrictions?

• Width restrictions?

• Length restrictions?

• Weight restrictions?

• Is the machine required to work internally or externally?

  Select Internal External

  • Internal
  • External

• Nature of Work

• What is the power source required?

  Select Diesel Lithium 110v Cable and 5kva Transformer 230v Cable (25m)

  • Diesel
  • Lithium
  • 110v Cable and 5kva Transformer
  • 230v Cable (25m)

• Ground Conditions

  Select Tiles Wooden floor Grass Tarmac Concrete Paving Slabs Other

  • Tiles
  • Wooden floor
  • Grass
  • Tarmac
  • Concrete
  • Paving Slabs
  • Other

• Are there any obstacles or potential hazards at site?

• If there are stairs to climb, please include the step depth, length and number of steps

• Is the hire self-drive or operated ?

  Select Self drive Operated

  • Self drive
  • Operated

• Length of hire ?

  Select 1 day 3 day 5 day 7 day

  • 1 day
  • 3 day
  • 5 day
  • 7 day

• What is the maximum working height?

• Maximum working outreach and at what height ?

• Are there any adverse ground conditions or slopes angles to travel +/or set up on?

• Will the hire require blocks, track mats, ply boards or larger spreader pads? How many ?

  Select Track Mats 6 Ply Boards 6 Sleepers 6 800mm pads 4 None

  • Track Mats
  • 6
  • Ply Boards
  • 6
  • Sleepers
  • 6
  • 800mm pads
  • 4
  • None

• How many set up positions are required at site for the works? Please attach a berthing plan in the drawing section if required

• Berthing Plan

  Media

Access, Transport and Traffic/Pedestrian Management

• What is the best method of transport for delivery?

  Select Mini Artic Class 2 - Rigid Class 1 - Artic

  • Mini Artic
  • Class 2 - Rigid
  • Class 1 - Artic

• Site Photographs - Entrance to Set-Up Location/s

  Media

• Does the site require PM +/or TM?

  Select TM PM Both TM and PM None

  • TM
  • PM
  • Both TM and PM
  • None

• Picture of road width

  Media

• Traffic count after 3 min

  Yes

  No

  N/A

• Special Notes and Additional Details (As much detail as possible)

• Hire Start Date

• Signed by Surveyor

  Sign

• 1st Choice Machine(s)

  Select PB13.80 (L) PB15.75m (L) PB15.75m Imer SA15.8 PB18.90 (L) Dino 18 PB20.95m (L) PB22.10m (L) Dino 22 Imer 23 PB27.14m (L) PB30m (L) FS330 PB33.15m (L) TM16 TM20 TM22 TM25 TM33 TM38 TM50 Other

  • PB13.80 (L)
  • PB15.75m (L)
  • PB15.75m
  • Imer SA15.8
  • PB18.90 (L)
  • Dino 18
  • PB20.95m (L)
  • PB22.10m (L)
  • Dino 22
  • Imer 23
  • PB27.14m (L)
  • PB30m (L)
  • FS330
  • PB33.15m (L)
  • TM16
  • TM20
  • TM22
  • TM25
  • TM33
  • TM38
  • TM50
  • Other

• 2nd Choice Machine(2)

  Select PB13.80 (L) PB15.75m (L) PB15.75m Imer SA15.8 PB18.90 (L) Dino 18 PB20.95m (L) PB22.10m (L) Dino 22 Imer 23 PB27.14m (L) PB30m (L) FS330 PB33.15m (L) TM16 TM20 TM22 TM25 TM33 TM38 TM50 Other

  • PB13.80 (L)
  • PB15.75m (L)
  • PB15.75m
  • Imer SA15.8
  • PB18.90 (L)
  • Dino 18
  • PB20.95m (L)
  • PB22.10m (L)
  • Dino 22
  • Imer 23
  • PB27.14m (L)
  • PB30m (L)
  • FS330
  • PB33.15m (L)
  • TM16
  • TM20
  • TM22
  • TM25
  • TM33
  • TM38
  • TM50
  • Other

• Signed by Customer (On Completion of Survey; accepting all information to be accurate and correct at the point of survey)

  Sign