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SCOPING FORM
SCOPING FORM
Anonymous

SCOPING FORM

FOR PLANNING AND SCOPING OF WORK ORDERS

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Free SCOPING FORM Checklist

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Title Page

  • Conducted on

  • Prepared by

  • Work Order Number

  • Work Order Directive

Validation - Initial check of information on the WO

  • Has the WO got the correct ObjectID?

  • Enter new value

  • Has the correct department been used?

  • Enter new department

  • Is the directive of good quality?

  • Enter new value

  • Is the priority correct?

  • Enter new value

Scoping

  • Any special access requirements?

  • Select type

    • Fixed scaff
    • Tower
    • Steps
    • Ladders
    • MEWP
    • Other - Leave note

  • Special PPE?

  • Select type

  • Lifting equipment required?

  • Type?

  • Fork Lift required?

  • Approx weight (Tons)

  • Special tools required?

  • Type?

  • Crane required?

  • What type?

Permit requirements

  • Isolations required (excluding self)

  • Note

  • Within rated area i.e. ATEX, COMAH

  • Note

  • Working at height with no edge protection

  • Note

  • Roof access

  • Note

  • Asbestos containing materials

  • Note

  • Hot work

  • Note

  • Breaking into pipelines

  • Note

  • Confined space

  • Note

  • Excavation

  • Note

  • High voltage work

  • Note

Materials Required

  • Description and quantity

Photos

  • Photo 1

  • Photo 2

  • Photo 3

  • Photo 4

  • Photo 5

SCOPING FORM
Anonymous

SCOPING FORM

FOR PLANNING AND SCOPING OF WORK ORDERS

Use this Template
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.

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