SSS Repair Scope Sheet

• Document No.

• Reference Number

• Branch Title

• Branch Number

• Site Contact

• Conducted on

  Date

• Prepared by

• General Description of the works

• Permits Needed

  Select Asbestos Low Voltage Working at Height Gas Systems

  • Asbestos
  • Low Voltage
  • Working at Height
  • Gas Systems

Please add tasks below which are required

Please also fill out Window and Door sections if necessary

• Work Neccessary

Task

• Description of Task

• Photos of Area of Work

  Media

• Task specific measurements

• Drawing if Neccessary

  Drawing

• Trade Needed

  Select Plumbing Electrical Carpentry Decorating Masonary Roofing Demolition/Groudworks

  • Plumbing
  • Electrical
  • Carpentry
  • Decorating
  • Masonary
  • Roofing
  • Demolition/Groudworks

• Scaffold Needed

• Photo of Scaffold position

  Media

• Estimated Height

• Are there Doors to replace

• Door Details

Door

• Measurements and Description

• Photo of existing door and position

  Media

• Door Material

  Select Plastic Wood Hardwood Metal

  • Plastic
  • Wood
  • Hardwood
  • Metal

• Are there Windows to replace

• Window Details

Window

• Measurements and Description

• Photo of existing window and position

  Media

• Window Material

  Plastic

  Wood

  Hardwood

  Metal

• By signing below you acknowledge that a representative of Woofenden Construction has discussed with you the Work Tasks within this report.

• Signature

  Sign