Site Survey Risk Assessment

• Client or site name:

• Job Ref:

• Client contact name and phone number

• Conducted on

  Date

• Prepared by

• Location
  Address

• Have you followed the signing in procedure?

  Yes

  No

  N/A

• Are you aware of the emergency arrangements?

  Yes

  No

  N/A

• Is there a permit to work system in place?

  Yes

  No

  N/A

Hazards, risks and control measures for Surveyor?

• Falls from a ladder?

  Select The ladders will be placed on firm level ground and be secured firmly at the top to prevent ladder slipping in any direction. Survey equipment items will be carried in a shoulder bag to ensure three points of contact at all times. The ladder will be long enough to access the roof area safely. It will extend at least one metre above the roof height.

  • The ladders will be placed on firm level ground and be secured firmly at the top to prevent ladder slipping in any direction.
  • Survey equipment items will be carried in a shoulder bag to ensure three points of contact at all times.
  • The ladder will be long enough to access the roof area safely. It will extend at least one metre above the roof height.

• Falls from mobile scaffolding tower?

  Select The access tower will be erected by a competent person on firm level ground with castors locked and outriggers in place. The tower is tagged or handed over by a competent person. The tower is not to be accessed in strong winds. The tower will be accessed through the internal ladder and access platforms, which are to be closed always.

  • The access tower will be erected by a competent person on firm level ground with castors locked and outriggers in place.
  • The tower is tagged or handed over by a competent person.
  • The tower is not to be accessed in strong winds.
  • The tower will be accessed through the internal ladder and access platforms, which are to be closed always.

• Falling from the roof edge?

  Select There is temporary or permanent edge protection in place. A parapet wall is present to a sufficient height (950mm) Surveyor will not need to be within 2m of an exposed edge. Safety harness to be worn and attached to a fixed anchor point

  • There is temporary or permanent edge protection in place.
  • A parapet wall is present to a sufficient height (950mm)
  • Surveyor will not need to be within 2m of an exposed edge.
  • Safety harness to be worn and attached to a fixed anchor point

• Falling through fragile surfaces?

  Select All fragile surfaces are made known and boarded up to protect. All fragile surfaces are made know and remain unprotected, but a dafe route has been determined away from all fragile surfaces. fragile surface is polycarbonate or GRP roof light/dome. Fragile surface is liner panels in built up roof Fragile surface is fibre cement sheet, corroded metal sheets, glass or wired glass Fragile surface is potential asbestos

  • All fragile surfaces are made known and boarded up to protect.
  • All fragile surfaces are made know and remain unprotected, but a dafe route has been determined away from all fragile surfaces.
  • fragile surface is polycarbonate or GRP roof light/dome.
  • Fragile surface is liner panels in built up roof
  • Fragile surface is fibre cement sheet, corroded metal sheets, glass or wired glass
  • Fragile surface is potential asbestos

• Falling from a MEWP?

  Select MEWP to be inspected and in date of thorough examination Competent persons to use the MEWP Harness to be used and attached to suitable anchor point in the basket.

  • MEWP to be inspected and in date of thorough examination
  • Competent persons to use the MEWP
  • Harness to be used and attached to suitable anchor point in the basket.

• Slips, Trips and falls?

  Select Route is planned to access roof Route is planned upon the roof No slips or trips present Safety footwear worn

  • Route is planned to access roof
  • Route is planned upon the roof
  • No slips or trips present
  • Safety footwear worn

• I have assessed the risks before undertaking the roof survey and there are adequate control measures in place to carry out the survey safely.

• Surveyor Name

  Sign