Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

This form assumes that the job cannot be completed by DTH or DAT Engineer. A form must be completed for each SAT job before it is undertaken. SAT jobs require two persons on site at all times With rope accessed jobs three people required 2 x level 1 trained and one Level 2 trained engineer at all times otherwise they postpone job.

Visit details

  • Address
  • Date and Time

  • Start time

  • True Job type

  • If job is DTH,SAT,ROPE ACCESS or impossible state why here

Access to height will be by

  • Ladder - Sky's fall arrest systems, eye bolting, ML and LM or equipment from the ladder hierarchy,etc.

  • Via a Dormer - Sky SAT procedures as trained with roped access techniques in use.

  • Via a velum window or rooflight - Sky SAT procedures as trained with roped access techniques in use.

  • Other means give details- Specify minimum control measures required.

Ladders used

  • 8 rung ladder - PPE microlite + eyebolt if necessary to ensure security

  • If a ML or LM cannot be used state what alternative is to be used. An eyebolt or other attachment point must be used for all dish installs and all service work.

  • Single section ladder- PPE microlite ladder mate full arrest + eyebolt

  • If a ML or LM cannot be used state what alternative is to be used. An eyebolt or other attachment point must be used for all dish installs and all service work.

  • Double section ladder- PPE microlite ladder mate full arrest + eyebolt

  • If a ML or LM cannot be used state what alternative is to be used. An eyebolt or other attachment point must be used for all dish installs and all service work.

  • Triple section ladder ( excluding full extension ) -PPE microlite ladder mate full arrest + eyebolt

  • If a ML or LM cannot be used state what alternative is to be used. An eyebolt or other attachment point must be used for all dish installs and all service work.

  • Triple 17's/15's ladder -PPE microlite ladder mate full arrest + eyebolt (two man required )

  • If a ML or LM cannot be used state what alternative is to be used. An eyebolt or other attachment point must be used for all dish installs and all service work.

  • Triple 19s ladder -PPE microlite ladder mate full arrest + 2 x eyebolt ( three man team required)

  • If a ML or LM cannot be used state what alternative is to be used. An eyebolt or other attachment point must be used for all dish installs and all service work.

  • Extended Cat ladder- PPE microlite ladder mate full arrest + eyebolt

  • If a ML or LM cannot be used state what alternative is to be used. An eyebolt or other attachment point must be used for all dish installs and all service work.

  • Combi ladder- PPE other equipment and fall arrest as necessary eyebolt at all times

  • If a ML or LM cannot be used state what alternative is to be used. An eyebolt or other attachment point must be used for all dish installs and all service work.

If Anchor points are needed for roped access are they

  • Existing and fixed ( in date and permission granted to use)

  • Add media

  • Temporary - eg 20mm eyebolt, primary plus back- up

  • Add media

  • Part of the building structure - checked and verified by both Engineers

  • Add media

On - site identified hazards

  • Adverse weather

  • Third parties

  • Traffic

  • Existing equipment

  • Garden hazards

  • Ground hazards

  • Any other hazards - state what they are

RE ACCESS SECTION VIP ONLY

Personnel on Site

  • Level 2 trained Supervisor on site

  • John Ware

  • Bob Loew

  • Andrew Wrenn

  • Darryl Fuller

  • Ricky Abrey

VIP Team on site

  • Robert Mangar

  • Matt Phillip

  • Martin Dowdy

  • Dane Thomas

  • Nick. Pover

  • Shaun Lucan

Equipment check

  • Kit number

  • Kit Number

  • Kit Number

  • 11mm Dynamic Ropes- 50 mtr each x 2

  • Neveho Harness c/w Chest Harness and Croll

  • Rocker

  • Hand Ascender

  • ID Descender Unit

  • 10mm Delta Maillon Rapide

  • 10mm Semi-Circular Maillon

  • 10mm Screwgate Karabiners (assorted)

  • Set of Cowstails 11mm Dynamic Rope

  • 7mm Plastic Covered Wire Anchor Strop - 375mm Long

  • 60cm Long Sewn Endless Webbing Slings

  • 1.2mtr Long Sewn Endless Webbing Slings

  • Petzl Helmet

  • Twin Leg Lanyards

  • Single Pulley Blocks

  • Double Pulley Blocks

  • Foot Loop Lanyard

  • 1mtr Canvas Rope Protector

  • Kite bag

  • Rope Bags

Team Communication

  • Visual (hand signals)

  • Verbal (unassisted )

  • Verbal (assisted)

  • Radio ( note channel)

Management

  • Equipment / Tool<br>

  • Access zone

  • Hazard Zone

  • Anchors

  • Rescue and Retrieval

Post visit Debrief

  • Safety Considerations- Where adequate safety measures taken to insure the safety of personnel and public

  • Anchorages used - Describe set up and any special techniques used

  • All equipment checked back into correct Kit bags

Work Log

  • Detail of task

  • Hours worked

  • Height Worked

  • Supervisor name

  • VIP Engineer name

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.