Title Page

Site

  • Site name

  • Client

  • Nature of works

  • Shift day/date

  • Start time

  • Finish time

  • Week №

Start Times

  • Published worksite time (see WON)

  • Published isolation times (see WON)

  • Worksite granted (ES to advise)

  • Form B granted (Nom to advise)

  • First Form C issued (Nom to advise)

  • Comments/reasons for delay

Finish Times

  • Worksite requested to be clear (ES to advise)

  • Form C requested return (Nom to advise)

  • Last Form C returned (Nom to advise)

  • Form B cancelled (Nom to advise)

  • Worksite cancelled (ES to advise)

  • Comments/reasons for delayed handback

  • TEF3203 required?

Works

    Works Completed

Description of Planned Works

  • Company

  • Activity

  • WPP №

  • TBS №

  • Comments

  • Actual work completed

  • Issues/delays/comments

Form Completed By

  • Signature

  • Date

Sign Off

Completion of Work Signed off by PiC

I confirm the SWP contents were appropriate. Select yes or no for each question and sign the declaration below.

  • Protection/warning arrangements were suitable for the work

  • Task risk & site risk controls were suitable for the work

  • Appropriate permits to work were included

  • Welfare facilities were appropriate

  • The work at site is completed and clear for the safe passage of trains

  • Any changes or additions that should be made to improve this form for future use?

  • undefined

  • Person in Charge

  • SWP №

  • Site photos

Form Completed By

  • Signature

  • Date

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.