Site Visit/Survey

• Conducted on

  Date

• Prepared by

• Location
  Address

• Client

• Site

• Date

  Date

• Visit by

  Select Gary Reader Robin Hambly Robert Burgoyne Jon Burgoyne Lee Millar Ben Pike

  • Gary Reader
  • Robin Hambly
  • Robert Burgoyne
  • Jon Burgoyne
  • Lee Millar
  • Ben Pike

• Seen by Client

• Weather

• Operative overseeing visit

  Select Richard Taylor Ashley Parrot Rob Lewis Chris Otley James Day Craig Smith Paul Scammell Jason Blake Aaron Otley Melvyn Day Harley Raby Asa Alvis Ben Stephens Ben Pike Ben Jones Jack Fry George Williams

  • Richard Taylor
  • Ashley Parrot
  • Rob Lewis
  • Chris Otley
  • James Day
  • Craig Smith
  • Paul Scammell
  • Jason Blake
  • Aaron Otley
  • Melvyn Day
  • Harley Raby
  • Asa Alvis
  • Ben Stephens
  • Ben Pike
  • Ben Jones
  • Jack Fry
  • George Williams

• Operatives present on site

  Select Richard Taylor Ashley Parrot Rob Lewis Chris Otley James Day Craig Smith Paul Scammell Jason Blake Aaron Otley Melvyn Day Harley Raby Asa Alvis Ben Stephens Ben Pike Ben Jones Jack Fry George Williams

  • Richard Taylor
  • Ashley Parrot
  • Rob Lewis
  • Chris Otley
  • James Day
  • Craig Smith
  • Paul Scammell
  • Jason Blake
  • Aaron Otley
  • Melvyn Day
  • Harley Raby
  • Asa Alvis
  • Ben Stephens
  • Ben Pike
  • Ben Jones
  • Jack Fry
  • George Williams

Safety

• Riddor

  Yes

  No

  N/A

• Near Misses

  Yes

  No

  N/A

• PPE Acceptable

  Yes

  No

  N/A

• Rams Visible for all

  Yes

  No

  N/A

• Changes of method of works anticipated

  Yes

  No

  N/A

• Tool box talk

  Yes

  No

  N/A

• Other Trades acceptable

  Yes

  No

  N/A

• Power Acceptable

  Yes

  No

  N/A

• CHSW Forms Complete

  Yes

  No

  N/A

• Unloading acceptable

  Yes

  No

  N/A

• Access and Fall protection adequate

  Yes

  No

  N/A

• Coshh adequate

  Yes

  No

  N/A

• welfare adequate

  Yes

  No

  N/A

Notes and pictures

• Please add notes if necessary

• Please upload pictures if necessary

  Media

Signatures

• Signature of person carrying out the survey

  Sign

• Signature of person over seeing the visit

  Sign

• Signature of the client

  Sign