SHIRE MAPPING

• prepared by

• Conducted on

  Date

• site id

• Location
  Address

• On behalf of

  Mbnl

  Ctil

  Other

  TEF

  Vodaphone

is the following in place

• first aid kit

  Yes

  No

  N/A

• rescue kit

  Yes

  No

  N/A

• emergency procedures

  Yes

  No

  N/A

• emergency numbers

  Yes

  No

  N/A

• spill kits

  Yes

  No

  N/A

• warning signs

  Yes

  No

  N/A

• rescue plan discussed

  Yes

  No

  N/A

general site hazards

• access and egress

  Safe

  At Risk

  N/A

• restricted areas

  Safe

  At Risk

  N/A

• asbestos

  Safe

  At Risk

  N/A

• noise

  Safe

  At Risk

  N/A

• confined spaces

  Safe

  At Risk

  N/A

• roof hazards

  Safe

  At Risk

  N/A

• fumes and gases

  Safe

  At Risk

  N/A

• hazardous substances

  Safe

  At Risk

  N/A

• hot and cold sustances

  Safe

  At Risk

  N/A

• vehicle movement

  Safe

  At Risk

  N/A

• ionizing radiation

  Safe

  At Risk

  N/A

• rf radiation

  Safe

  At Risk

  N/A

• high voltage electricty

  Safe

  At Risk

  N/A

• gas and steam

  Safe

  At Risk

  N/A

• fire and explosion

  Safe

  At Risk

  N/A

• machinery

  Safe

  At Risk

  N/A

• lift motor rooms

  Safe

  At Risk

  N/A

• automated plant

  Safe

  At Risk

  N/A

• battery rooms

  Safe

  At Risk

  N/A

• lighting

  Good

  Fair

  Poor

  N/A

tower hazards

• Aplicable

  Yes

  No

  N/A

• working at Hight

  Yes

  No

  N/A

• fixed fall arrest in date

  Yes

  No

  N/A

• entry into ductwork

  Yes

  No

  N/A

• ppe

  Yes

  No

  N/A

• rf indication

  Yes

  No

  N/A

• lifting in progress

  Yes

  No

  N/A

• weather conditions

  Good

  Fair

  Poor

  N/A

roof hazards

• Applicable

  Yes

  No

  N/A

• fragile surfaces

  Yes

  No

  N/A

• trip hazards

  Yes

  No

  N/A

• no barrier or para pit

  Yes

  No

  N/A

• use of ladders

  Yes

  No

  N/A

• bird faeces

  Yes

  No

  N/A

• entry into ductwork

  Yes

  No

  N/A

• manual handling

  Yes

  No

  N/A

• weather conditions

  Good

  Fair

  Poor

  N/A

MEWP hazards

• Applicable

  Yes

  No

  N/A

• traffic hazards

  Yes

  No

  N/A

• pedestrians

  Yes

  No

  N/A

• ground conditions

  Good

  Fair

  Poor

  N/A

• machine suitability

  Good

  Fair

  Poor

  N/A

• machine inspection cert

  Yes

  No

  N/A

• ppe

  Yes

  No

  N/A

• weather conditions

  Good

  Fair

  Poor

  N/A

excavation hazards

• Applicable

  Yes

  No

  N/A

• working at height

  Yes

  No

  N/A

• underground services

  Yes

  No

  N/A

• contaminated ground

  Yes

  No

  N/A

• entry in to ductwork

  Yes

  No

  N/A

• ppe

  Yes

  No

  N/A

• lifting in progress

  Yes

  No

  N/A

• weather conditions

  Good

  Fair

  Poor

  N/A

RAMS

• Have the rams been seen by everyone on site

  Yes

  No

  N/A

• attendees on site

• take photo of access

  Media

• take photo of signage

  Media

• photo of emc

  Media

• photos of cabins and equipment

  Media

• photos of structure

  Media

• Feeder count

• Photo of feeder run

  Media

• photo of foundation

  Media

• photo of connection to foundation

  Media

• What is the connection to foundation

  Holding down plate

  Cast in bolts

  Cast in leg

  other

• holding down plate thickness

• holding down plate size

• number of bolts

• size of bolts

• number of bolts

• size of bolts

• gap between foundation and under side of plate

• size of plate

• bolt centers

• bolt centres

• please provide photo

  Media

• size of leg

• please describe connection

• please provide photo

  Media

• tower type

  lattice

  monopole

  roof top stub tower

  rooftop wall mounted

• what type of tower leg

  CHS

  RSA

  OTHER

• CHS diameter

• CHS thickness

• leg to leg at base

splice

• height to centre line

• type of splice

  bolted flange plate

  bolted flat plate

• size of splice plate

• number of bolts

• bolt size m

• leg to leg

• tower leg size

• brace size

• brace bolt size

• number of brace bolts

• vertical gap in brace

• leg to leg at base

• what size RSA (WxWxT)

splice

• height to centre line

• type of splice

  bolted flange plate

  bolted flat plate

• size of splice plate

• number of bolts

• bolt size m

• leg to leg

• tower leg size

• brace size

• brace bolt size

• number of brace bolts

• vertical gap in brace

• What is the tower leg

splice

• number of faces

• face width

• height of splice

• type of splice

  turfed

  welded

  other

• face thickness

• Yes

  No

  N/A

• Yes

  No

  N/A

• leg to leg at top of tower

• Top of tower height (m)

Equipment

• Height (m)

• Location

  Headframe

  Leg

  other

• Number

• Type

• Operator

  Mbnl

  Vodafone

  02

  Airwave

• Bearing

• Feeders

• Feeder location

  Leg

  Ladder

• Photo of equipment

  Media

• What other operators are on site

  Select Mbnl Vodafone TEF Airwave Other

  • Mbnl
  • Vodafone
  • TEF
  • Airwave
  • Other

• Note other OLO and centre line heights

• OLO photos

  Media

• Provide cabin sketch

  Media

• Provide base sketch

  Media

• Provide head frame sketch

  Media