Title Page
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Conducted on
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Prepared by
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On behalf of :
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Weather conditions
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Team 1 Site Location/ ELR and Mileage
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Team 2 Site Location/ ELR and Mileage
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Team 3 Site Location/ ELR and Mileage
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Site Hours
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Any lost time/hours
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Possession Start time or Shift time
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Possession End Time or Shift time
Planned Works V Actual
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Planned Works
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Actual Work Team 1
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Actual work Team 2
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Actual Work Team 3
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If Shortfall, reason why
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Reason for delay to task
Resources
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How Many team's on site today
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Members of staff on site
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Members of staff on site Team 1
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Members of staff on site Team 2
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Members of Staff on site Team 3
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Delivery Team or Team's
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PPE
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What Welfare is being used
Plant & Equipment
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RRV's /Plant / Attachments and Van's
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Small Plant
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Breakdowns
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Lost time on plant down
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Equipment suitable for the works
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Lighting sufficient for the task
Photos
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Photos Team 1
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Photos Team 2
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Photos Team 3
Any Issues
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Technical Queries
Inspections
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Is lighting Sufficient for the task
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House Keeping
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Welfare
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First Aid kits on site
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Paperwork on site
Defects
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Defects found
Close Calls / Good Working Practices
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Close calls
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Comments
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Good Working Practices
Signatures
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AIW Representative