Scoping Sheet

• Site

• Date

  Date

• Prepared by

• Location
  Address

• Instructions
  1. Please answer the questions accordingly.
  2. Add photos and notes by clicking on the paperclip icon
  3. To add a Corrective Measure click on the paperclip icon then ""Add Action"", provide a description, assign to a member, set priority, and due date
  4. Complete audit by providing digital signature
  5. Share your report by exporting as PDF, Word, Excel or Web Link

• 1. Work Request Number

• 2. Job Description

• 3. Priority

  1. IMMEDIATE — Next 24hrs

  2. URGENT — Next 7 Days

  3. HIGH — Next available period

  4. LOW — When Schedule Allows

  5. Down Day — Next Scheduled

• 4. Photo numbers:
  #Note: Photos close and at distance required to assist with parts identification and job interaction

•Photo

• Take relevant photos

  Media

• 5. Does the defect require a temporary repair to keep plant running until parts are sourced and installed? ie. Patch a hole in a leaking pipe until new pipe is installed

• 6. List simple job steps and whether they can be completed while plant is running or shutdown, include trades required and hours to complete

•job Step

• Specify and Provide details

• 7. Parts/materials required

•Parts/materials

• Specify and Provide details

• Take Relevant Photo

  Media

• 8. Equipment required

•Equipment

• Specify and Provide details

• 9. Clean Up required

•Clean Up

• Specify and Provide details

• Take Relevant Photo

  Media

• 10, Check isolation points accessible, record asset numbers and photograph

•Isolation Point

• Specify and Provide details

• Take Relevant Photo

  Media

Signatory

• Prepared By: (Full Name and Signature)

  Sign