Information

  • Request number:

  • Location
  • Conducted on

SCC VISUAL TREE ASSESSMENT

  • Assessment Officer

  • Name of person conducting VTA

  • Request Number

  • Address
  • Additional location information

  • Species

  • Tree Condition / Assessment Notes

  • Tree Assessment Photos

HAZARD RATING

  • VTA Reference notes

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  • Target

  • Impact

  • Consequence (target + impact)

  • Likelihood

  • Hazard Rating

OPERATIONAL RECOMMENDATIONS

  • Hazard Abatement / Action Required

  • Climb or Elevated Work Platform required

  • Tower size

  • Stump grind required

  • External traffic control required

  • Works to be conducted by

  • Notes

  • Site specific hazards are required to be identified by work crews and risk assessments completed prior to works commencing.

REPLACEMENT PLANTING

  • Replacement tree required

  • Recommended species

NOTIFICATION

  • Customer advised

  • Letter to adjoining residents required

  • Councillor advised

  • Notes relating to notification

  • Signature

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.