Title Page
Site
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Site name
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Client
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Nature of works
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Shift day/date
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Start time
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Finish time
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Week №
Start Times
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Published worksite time (see WON)
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Published isolation times (see WON)
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Worksite granted (ES to advise)
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Form B granted (Nom to advise)
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First Form C issued (Nom to advise)
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Comments/reasons for delay
Finish Times
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Worksite requested to be clear (ES to advise)
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Form C requested return (Nom to advise)
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Last Form C returned (Nom to advise)
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Form B cancelled (Nom to advise)
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Worksite cancelled (ES to advise)
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Comments/reasons for delayed handback
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TEF3203 required?
Works
- Works Completed
Description of Planned Works
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Company
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Activity
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WPP №
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TBS №
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Comments
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Actual work completed
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Issues/delays/comments
Form Completed By
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Signature
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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.
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Protection/warning arrangements were suitable for the work
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Task risk & site risk controls were suitable for the work
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Appropriate permits to work were included
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Welfare facilities were appropriate
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The work at site is completed and clear for the safe passage of trains
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Any changes or additions that should be made to improve this form for future use?
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Person in Charge
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SWP №
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Site photos
Form Completed By
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Signature
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Date