Talk Talk City Fibre Survey - SCCI

• Client / Housing Association

• Job number

• System Type

• Number of dwellings

• Conducted on

  Date

• Surveyor

• Address

• Post code

Site details

• Parking availability

  Select Estate Road Meter Permit None Other

  • Estate
  • Road
  • Meter
  • Permit
  • None
  • Other

• Site contact and contact details

• Access requirements to enter the block

Description of Civil Works

• Hard dig (drive way / parking way)

  Yes

  No

• Quantity & Remarks

• Hard dig (Bitumen)

  Yes

  No

• Quantity & Remarks

• Hard dig (Paving Slabs)

  Yes

  No

• Quantity & Remarks

• Hard dig (are any already broken paving slabs)

  Yes

  No

• Quantity & Remarks

• Hard dig (block paving)

  Yes

  No

• Quantity & Remarks

• Soft dig (gravel)

  Yes

  No

• Quantity & Remarks

• Soft dig (verge)

  Yes

  No

• Quantity & Remarks

• Break out and make good

  Yes

  No

• Quantity & Remarks

• Replace curb stones

  Yes

  No

• Quantity & Remarks

• Mechanical Protection (containment)

  Yes

  No

• Quantity & Remarks

• Core drill holes

  Yes

  No

• Quantity & Remarks

• Fire stopping holes

  Yes

  No

• Quantity & Remarks

• Access Equipment (MEWP)

  Yes

  No

• Quantity & Remarks

• Break out and make good under walls

  Yes

  No

• Quantity & Remarks

• Catenary cable

  Yes

  No

• Quantity & Remarks

• Additional Health and Safety considerations

  Yes

  No

• Quantity & Remarks

• Miscellaneous

  Yes

  No

• Quantity & Remarks

• Reinstatement type

  Yes

  No

• Quantity & Remarks

Talk Talk system

• Outline of methodology of installation

CAT and Genny

• Has CAT and Genny survey been carried out?

  Yes

  No

• Undertake survey before installation commences

Asbestos

• Asbestos - Has any been identified on site?

  Yes

  No

• Ask for the asbestos register

  Yes

  No

  N/A

• Has asbestos been identified in work areas?

  Yes

  No

  N/A

• If asbestos is suspected in the area you are working, work must be stopped immediately and reported to project management. Works will only continue when an asbestos survey of the affected work area has been carried out by a competent person/company and is either declared safe to work in or an alternative method of working has been found. The clients asbestos register must be scanned in the specific areas before any further works are undertaken.

• Yes

  No

  N/A

• Any other issues that may cause delay with installation

  Yes

  No

• Please give details

Other Information

• Address of Nearest Hospital
  Address

• Details of welfare facilities

Hazard Present (General Activities)

• A1. Access into lift motor room via loft ladders

  Yes

  No

  N/A

• HARM - Serious Injuries or Death
  PERSONS AT RISK - Operatives / Members of public
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -Area must be cordoned off, by means of cones, barrier tape and warning signage. The access hatch must always be kept closed when not in use to prevent unauthorised entry.

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• A2. Asbestos exposure

  Yes

  No

• HARM - Ill health from exposure to asbestos
  PERSONS AT RISK - Operatives / Members of public
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED - If asbestos is suspected in the area you are working, work must be stopped immediately and reported to project management. Works will only continue when an asbestos survey of the affected work area has been carried out by a competent person/company and is either declared safe to work in or an alternative method of working has been found. The clients asbestos register must be scanned in the specific areas before any further works are undertaken

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• A3. Dust exposure

  Yes

  No

• HARM - Ill health from exposure to dust inhalation
  PERSONS AT RISK - Operatives / Members of public
  RISK RATING- Medium

• CONTROL MEASURES TO BE IMPLEMENTED - Face masks must be worn at all times whilst drilling or in dusty environments. Area must be cordoned off, by means of cones, barrier tape and warning signage to warn people of works taking place

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• A4. Electrical hazards and access to moving machinery in lift motor room

  Yes

  No

• HARM - Entanglement, entrapment, electrocution
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED - Lift motor rooms should not be entered unless it is required for access or egress to another part of the building e.g. roof. Care should be taken due to high voltages and this area should never be used as storage for equipment. Access to these areas must be monitored at all times by either supervision or a permit to work system.

• Additional control measures required?

• Any Additional Control Measures Required?

• A5. Environmental hazards/Bees/Wasps/Vermin and hazardous waste

  Yes

  No

• HARM - Potential of contracting various diseases
  PERSONS AT RISK - Operatives / Members of the public
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED - If any environmental hazards such as wasps/bees nests/vermin/ hazardous waste etc are discovered, then work is to stop immediately and contact client/office to instigate a competent contractor to remove hazard.

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• A6. Exit from lift motor room onto roof within 2m of roof edge

  Yes

  No

• HARM - Serious Injuries or Death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Operatives are to attach to a suitable anchorage point via a fixed or inertia lanyard so maintain a minimum of 2 metres from any unprotected edge.

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A7. Drilling activities

  Yes

  No

• HARM - Eye Injuries due to dust particles
  PERSONS AT RISK - Operatives
  RISK RATING- Medium

• CONTROL MEASURES TO BE IMPLEMENTED -. Eye protection must be worn at all times when drilling to avoid eye injuries occurring

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• A8. Falls from Heights using Ladders and access equipment

  Yes

  No

• HARM - Serious Injuries or Death
  PERSONS AT RISK - Operatives / Members of the public
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. All operatives must have a valid working at heights certificate. Ladders must be in good condition and set on level ground at the correct angle (1 in 4). Where this cannot be achieved, additional stabilising devices must be employed. All ladders are to be secured by eye bolts and straps.
  Safety harnesses must be worn and attached using rope and cowl when three points of contact cannot be maintained.

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A9. Falls from Heights when using scaffolding

  Yes

  No

• HARM - Serious Injuries or Death
  PERSONS AT RISK - Operatives / Members of the public
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Operatives must under no circumstance access a incomplete scaffold unless it has been inspected by a competent person and tagged I to say it is "safe to use"(This must be done every 7 days). Scaffold must only be altered/erected by a company approved/competent person. If in any doubt, contact a member of the Health & Safety Department.

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A10. Manual Handling

  Yes

  No

• HARM - Serious back damage, sprains or torn ligaments
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Operatives to assess for Load (What is it that you are going to lift), Individual (Are you up to the lift), Task (Does the task need to be done manually or can it done by other means i.e. mechanical devices?) and Environment (What are the conditions and do you have a clear route?). All have been trained in manual handling technique

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• A11. Slips and Trips

  Yes

  No

• HARM - Strains, broken legs, arms, head injuries
  PERSONS AT RISK - Operatives
  RISK RATING- Medium

• CONTROL MEASURES TO BE IMPLEMENTED -. Operatives to ensure that: • All work areas will be regularly inspected to ensure that good standards of “housekeeping” are maintained at all times.
  • Appropriate protective clothing must be worn, especially safety footwear.
  • Operatives are required to take reasonable care of their own safety when working and moving about a site. This means keeping their work area clean and tidy at all times.

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• A12. Unsafe ground conditions (I.E - uneven or soft)

  Yes

  No

• HARM - Serious injuries or Death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Levelling device to be used on ladder where ground is uneven. Use designated pathways. If unable to do this please contact your Project Manager.

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A13. Weather conditions (i.e severe gales or snow etc.)

  Yes

  No

• HARM - Falls from height, Serious injuries or Death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. In the event of excessive weather work will be stopped specifically high winds on MEWP, Ladders, Cradles and roof works. Also extra care is needed when working in snow and ice. Under no circumstances should work continue in these circumstances. If significant risk is present, contact the Health & Safety Department

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• A14. Un-cooperative residents or members of the public

  Yes

  No

• HARM - Possibility of being attacked by abusive resident or member of public
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Operative to avoid confrontation with residents/members of the public and walk away from situation. This must be reported to management and the Health & Safety Department Immediately

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• A15. Presence of needle injuries inside properties and buildings

  Yes

  No

• HARM - Needle injuries, possibility of contracting serious diseases
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Operators to be extra vigilant and cautious when working in properties and buildings. If needles are found, work must stop immediately. You must inform Project Management and leave the area. If injuries are sustained, you must attend the nearest hospital immediately.

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A16. Falls from Height whilst on a pitched roof

  Yes

  No

• HARM - Serious injuries or Death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Cat ladders must be used on all pitched roof works. Access ladders must extend 1.2 metres above gutter line and must be secured at the top with a stand off and bottom with ratchet straps, stabiliser and eye bolts. Cat ladder must span the roof fully, have a rope system attached and be strapped to the access ladder.

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A17. Falls from Height whilst on pitched roof with no apex

  Yes

  No

• HARM - Serious injuries or Death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Operatives to use a rope safety line attached to eyebolts at each end of the roof. Safety harnesses to be attached to safety line at all times whilst working on roof. Work must cease in wet or windy conditions.

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A18. Raising materials to height using pulley system

  Yes

  No

• HARM - Serious injuries
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Materials to be raised to height using a rope pulley system. A failsafe rope is to pass through an automatic anti reverse belay pulley attached to the top of the ladder and through an automatic rope grab attached to bottom of ladder.
  

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A19. Working on an unprotected flat roof

  Yes

  No

• HARM - Falls from height, Serious injuries or Death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -.When no edge protection is provided, a 2 metre exclusion zone must be set up. To work within the 2 metre exclusion zone, operatives must be attached to a dead mans anchor then from the anchor a fixed lanyard/rope system is used. If in doubt contact the Health & Safety Department

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A20. Working in access roads, car parks or public places

  Yes

  No

• HARM - Injuries to members of the public, slips &trips or head injuries fro falling objects
  PERSONS AT RISK - Operatives / Members of the public
  RISK RATING- Medium

• CONTROL MEASURES TO BE IMPLEMENTED -.Operatives are to ensure that work areas are cordoned off with cones, barrier tape and suitable signage to prevent un-authorised entry. If possible try to minimise works within these areas. If working in a public highway, works must comply with the New Road Street Works Act 1991.

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A21. Accessing a loft without internal loft ladder

  Yes

  No

• HARM - Falls from height, Serious injuries or Death
  PERSONS AT RISK - Operatives / Members of the public
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. If we need to access the loft then at survey stage a request is to be made to the client that he supplies one that is fit for purpose. If this is not possible then a extendable ladder should be used provided it can be secured to the wall via a eyebolt & ratchet strap or held at the base by a second person. Signage, cones and warning tape must be used at the base of the entry point. Ensure that prior to entry that there is adequate lighting and the loft can sustain your weight. If unsure seek advice from the Project Manager responsible.

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A22. Loft work

  Yes

  No

• HARM - Falls from height, Serious injuries or Death from falling through ceiling
  PERSONS AT RISK - Operatives / Residents in block
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Crawl boards may be required to undertake activities in the loft. Lighting will be needed to reduce risk of injury. Face masks, Hard hats , Hi Vis, gloves , goggles & dust masks to be worn at all times. Possible breathing apparatus may be required.

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A23. Accessing a flat roof that does not have anchor points

  Yes

  No

• HARM - Falls from height, Serious injuries or Death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. A mobile man anchor must be used and the operative must be attached using a fixed restraint device that prevents a fall from the edge of the roof. If the works allows, it is preferable to maintain a 2m exclusion zone to limit the risk of a fall. If you need to gain closer access to the edge, this must be within 1m and a fixed lanyard must be used. NO EXCEPTIONS

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A24. Working on flat roof that has edge protection

  Yes

  No

• HARM - Falls from height, Serious injuries or Death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. When working on a roof that has edge protection, this must be at least 950mm high as a minimum requirement. If you are unsure, then contact project manager or Health & Safety Department for further advice/guidance.
  

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A25. Discovery of pirate radio aerials

  Yes

  No

• HARM - Threats of violence, possibility of being attacked
  PERSONS AT RISK - Operatives / Members of the public
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. If you discover anything to do with pirate radio, work must stop and you must leave site immediately. Contact project management immediately for further advise

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• A26. Removal of waste

  Yes

  No

• HARM - Serious back damage, sprains, torn ligaments
  PERSONS AT RISK - Operatives / Members of the public
  RISK RATING- Medium

• CONTROL MEASURES TO BE IMPLEMENTED -. All waste that is created on site such as cardboard, cable, wood, metal brackets, bricks and electrical equipment must be taken back to Head office/depot at the end of each working day where it is must be segregated into the correct skips/bins. This will then be taken away by a licensed waste contractor

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• A27. Drilling in properties on high level (falling debris)

  Yes

  No

• HARM - Injuries to passing pedestrians, falling debris
  PERSONS AT RISK - Operatives / Members of the public
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Before drilling through walls in properties 1 storey and above where there is a risk to the public from falling debris in places such as shops, public foot paths/pavements, roads, communal areas of properties such as gardens and patio areas), an area wide enough directly below on the outside must be cordoned off with cones, barrier tape and clear warning signage to prevent unauthorised access. A second man must be used to hold the net basket inside the property to catch any brick dust or falling debris. Always use a scanner before drilling into any wall.

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A28. Access above a low level flat roof

  Yes

  No

• HARM - Serious Injuries or Death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Operatives must not stand on the flat roof at any time. Cables to be suspended on a cat wire made on floor then ladder secured in position with eye bolts on either side of roof with a rope system in place to attach harness to and a stabiliser at the bottom of the ladder

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A29. Access above a low level pitched roof

  Yes

  No

• HARM - Serious Injuries or Death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Operatives must not stand on the pitched roof at any time. Cables to be suspended on a cat wire made on floor then ladder secured in position with eye bolts on either side of pitched roof with a rope system in place to attach harness to and a stabiliser at the bottom of the ladder.

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A30. Overhead lines (striking of telephone or power lines)

  Yes

  No

• HARM - Serious Injuries or Death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Equipment must not be used in vicinity of overhead lines. Additional care must be taken when moving ladders as to not to strike the lines. This must be a two man operation. Should the work be too close to lines, stop and contact project manager or Health & Safety Department for further advice

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A31. Electric shock

  Yes

  No

• HARM - Serious Injuries, Burns or Death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. It is essential to carry out all necessary precautions to ensure all cables, junction boxes, sockets and fittings are not damaged in any way and are safe to use. Provide an accessible and clearly identified switch near each fixed machine to cut off power in event of an emergency. Be aware of first aid procedures in the event of an electrical shock. The use of RCD (Residual Current Device) if using equipment operating at 230 volts or higher can provide additional safety. Either, build it into main switchboard or the socket outlet as this means the supply cables are permanently protected. If this is not possible, a plug incorporating and RCD or a plug in RCD adaptor can also provide additional safety.

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A32. Alternating current electrocution

  Yes

  No

• HARM - Serious Injuries or Death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Isolation procedures must be followed and electrical supplies must be locked off as necessary. An electrical permit to work must be used and any electrical circuits must be verified as "Dead".

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A33. Working in a confined space

  Yes

  No

• HARM - Serious Injuries or Death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Ensure adequate lighting is available prior to entry. Bump cap to be worn at all times whilst working in confined space to avoid head injuries. All items must be removed from the confined space before entry and a safe working area must be established.

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A34. Excavations

  Yes

  No

• HARM - Serious Injuries or Death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. If there are any excavations to be carried out, this must be done by a trained and approved contractor. Services such as gas, electricity and water must be identified prior to works commencing using CAT scanner, utility drawings and if necessary, isolating services so works can be carried out safely. The utility companies must be called if there is a perceived risk of striking any other cables or utilities (Competent contractor to provide a full safe system of work that must be reviewed by Health & Safety Department).

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A35. Working in residents or communal gardens

  Yes

  No

• HARM - Serious Injuries or Death
  PERSONS AT RISK - Members of the public
  RISK RATING- Medium

• CONTROL MEASURES TO BE IMPLEMENTED -. Cones, barrier tape and warning signage to be in place around work area and adequate signage to be in place at all entrances, exits of the building and along all pathways.

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• A36. Cutting metal materials with hand saw

  Yes

  No

• HARM - Eye injuries due to metal fragment, cuts to hand when handling metal.
  PERSONS AT RISK - Operatives
  RISK RATING- Medium

• CONTROL MEASURES TO BE IMPLEMENTED -. Eye protection and gloves to be worn at all times when cutting metal using a hand saw. Hand saw must be checked by operatives before and after use. Any defects must be reported to project management immediately.

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• A37. Exposure to noise from drilling or loud machinery

  Yes

  No

• HARM - Loss of hearing or partial deafness
  PERSONS AT RISK - Operatives
  RISK RATING- Medium

• CONTROL MEASURES TO BE IMPLEMENTED -. Hearing protection must be worn when undertaking noisy activities such as drilling. Noise levels must not exceed 85 dba. If unsure, contact project manager or Health & Safety Department for further advise.

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• A38. Chemical Hazards (Hazardous substances)

  Yes

  No

• HARM - Risk of burns, inhalation and ingestion
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. In order to reduce the risk of exposure to hazardous substances, the following measures will be implemented:
  • An inventory of all substances hazardous to health in use by the company will be compiled and maintained together with appropriate hazard information. This can be obtained from the Health & Safety Department.
  • All operatives involving, or which may involve, exposure to substances hazardous to health will be medically assessed.
  • Appropriate control measures will be implemented if it is not possible to eliminate, or substitute for a hazardous substance (See separate risk assessment).
  

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A39. Inadequate First Aid provisions

  Yes

  No

• HARM - Sustaining Injuries
  PERSONS AT RISK - Operatives
  RISK RATING- Medium

• CONTROL MEASURES TO BE IMPLEMENTED -. Operatives must ensure they have a first aid box which is a minimum of a 1-10 man kit. It must be adequately stocked and meets legal compliance. Operatives must have a minimum standard of first aid training to comply with the First Aid at work regulations 1981.

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• A40. Fire prevention and escape routes

  Yes

  No

• HARM - Serious Injuries or Death
  PERSONS AT RISK - Operatives / Members of the public
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Operatives must ensure before works commence that they know where the escape routes and assembly points are located. Operatives are only allowed to use fire extinguishers if they have had the necessary training. Operatives to follow site emergency procedures at all times.

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A41. Potential non-ionising Radiation exposure from transmitters on roof

  Yes

  No

• HARM - General sickness, limb weakness. nausea, headaches. flu like symptoms
  PERSONS AT RISK - Operatives
  RISK RATING- Medium

• CONTROL MEASURES TO BE IMPLEMENTED -. Maintain a 2m exclusion zone away from the transmitters or if possible, ask for the transmitters to be switched off. If any sickness is identified, the operative concerned must inform the client, and leave site immediately to take further medical advice – e.g. go to local hospital.

• Additional control measures required?

• Any Additional Control Measures Required?

• RESIDUAL RISK - Low

• A42. Work Equipment

  Yes

  No

• HARM - Serious Injuries
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. When working with any work equipment, operatives must ensure the following:
  • Work equipment will be maintained in efficient working order, good repair and inspected before and after use. Any defects must be reported to the Health & Safety Department immediately.
  • Operatives must ensure that they are trained before using any work equipment in their correct operation.
  • Operatives to ensure that they wear necessary protective clothing (such as hi viz, safety boots, gloves and where applicable, eye protection and dust masks.
  • Operatives to use work equipment in the manner and for the purpose, which they were intended for use.

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A43. Using electrical equipment in wet areas or conditions

  Yes

  No

• HARM - Serious injury, Electrocution, Death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Ensure that equipment is suitably insulated and only tested equipment is used which has been checked by a competent person. In severe environmental conditions the use of electrical equipment must not be used and must be reported to the Health & Safety Department immediately. If working in the vicinity of the pool area, the use of a R.C.D. should be used and the use of a transformer to reduce the electrical voltage to 110V.
  

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A44. High risk maintenance works or complex installations

  Yes

  No

• HARM - Serious injury or Death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. A Permit To Work must be used in any situation where the work is of high risk to operatives. Operatives must be fully briefed of conditions set out in permit and must be signed for by an authorised person. All work areas must be segregated from members of the public by using cones, barrier tape and warning signage. At the end of works, engineers must check area to ensure that it is safe and poses no risk to members of the public. Authorised person will then check area fully and sign off permit to say works are completed.

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A45. Trailing cables from static or portable electrical equipment

  Yes

  No

• HARM - Serious injury, trips or burns
  PERSONS AT RISK - Operatives / Members of the public
  RISK RATING- Medium

• CONTROL MEASURES TO BE IMPLEMENTED -. Cable clips must be used to tie cables together. Use hazard tape to secure cables to floor/wall etc, or the use of a cable run to prevent any slips, trips & falls. Consider installing new sockets to prevent any trailing cables and use appropriate signage to show trailing cables if you are using a portable electrical item such as a vacuum cleaner. Portable electrical equipment should be used out of hours wherever reasonably practicable.

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• A46. Faulty Cables on electrical equipment (visual only)

  Yes

  No

• HARM - Serious injuries, electric shock, Death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Visual checks of cables should be carried out by a competent person at specified times (i.e. Before use, weekly, monthly or annually depending on the type of equipment). Further advice can be obtained from the Health & Safety Department.

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A47. Switch rooms and Fuse boards

  Yes

  No

• HARM - Serious injuries, electric shock, Death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Ensure that distribution board circuits are correctly labelled. Keep area locked/secured at all times and ensure good housekeeping is adhered to. Must ensure that fixed installation testing is carried out by a competent person every 5 years. Further advice can be obtained from the Health & Safety Department.

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• A48. Fire caused by an electrical fault

  Yes

  No

• HARM - Smoke inhalation, Burns, Death
  PERSONS AT RISK - Operatives / Members of the public
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Ensure that visual checks are carried out on a regular basis (i.e. Before use, weekly, monthly and annually). Ensure that wires are not fraying as this can cause arcing. Further advice can be obtained from the Health & Safety Department

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

Access equipment - Works with MEWP

• Is a Cherry Picker (MEWP) Required?

  Yes

  No

• B1. Electricity/electrocution

  Yes

  No

• HARM - Electrocution, serious injuries, death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. This must be identified at survey stage, If there is even a remote chance that an overhead cable could be struck then work must be stopped immediately. Do not continue to operate the equipment. Get advice from Project Manager. Check the area above for any electrical lines or any cables that may come into contact with equipmen

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• B2. Equipment Failure

  Yes

  No

• HARM - Failure of equipment causing serious injuries or death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Equipment to be maintained and examined as per LOLER Regulations. All mechanical parts to be included in MEWP engineers examination. Equipment to be tagged and valid certification to be held on equipment. Operator must carryout pre-start checks as per training that they have had.
  

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• B3. Falls and falling objects

  Yes

  No

• HARM - Injuries to persons below from falling objects
  PERSONS AT RISK - Operatives / Members of the public
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. No materials to hang over the platforms handrails. Operator must not hang over the handrails. Equipment not to be overloaded. Work area to be cordoned off with cones, barrier tape and warning signage. If working in a public highway must comply with the New Road Street Works Act 1991
  

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• B4. Operating MEWP

  Yes

  No

• HARM - Falls from heights, Serious injuries or Death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -.Only competent trained personnel holding valid certification to operate equipment. It must be fully tested and hold current certification. Equipment risk assessment to be read, understood, and signed by operatives. It must be made available on equipment at all times.

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• B5. Overhead Lines (Striking of electricity lines)

  Yes

  No

• HARM - Striking electrical cables / electrocution
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -.Area to be assessed for overhead lines at survey stage if possible. Under no circumstances must equipment be used in vicinity of overhead lines unless otherwise stated.

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• B6. Overloading of equipment

  Yes

  No

• HARM - Failure of equipment causing serious injuries or death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. The equipment will not be overloaded and will fall within the specified safe working load. The operator will be fully qualified and conversant with the operational aspects of the equipment.

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• B7. Parking of MEWP

  Yes

  No

• HARM - Un-authorised persons using MEWPS resulting in damage to pavements and services resulting in possible serious injury or death
  PERSONS AT RISK - Operatives / Members of the public
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Vehicle to be left in a safe place, all electrics to be isolated and keys kept by the operator so no unauthorised use can take place. This may include having physical barriers to prevent unauthorised access. Floor track mats must be used at all times to prevent damage to ground and pavements. Use of MEWPS on footpaths should be avoided where possible due to the amount of services being buried underneath.

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• B8. Servicing equipment

  Yes

  No

• HARM - Failure of equipment causing serious injuries or death
  PERSONS AT RISK - Operatives / Members of the public
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Only a qualified engineer will service/repair the equipment. All repairs/services will comply with LOLER regulations. The engineer will comply with site rules conditions. Equipment will be isolated and ignition keys removed before any hatches or guards are removed from the equipment. Engineer will be fully aware of the Equipment risk assessment.

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• B9. Siting and setting up of MEWP

  Yes

  No

• HARM - Falls from Height, serious injuries or death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Suitably competent and qualified operator to CITB or IPAF standard. Initial pre-start checks/Inspection prior to operation to ensure safe working. Machine setup and levelled in accordance with manufacturers instructions. Suitable firm level ground conditions with no slopes, underground services manholes, obstructions. Outriggers/stabilisers to be properly set up with spreader pads utilised as necessary to spread load and prevent sinking. Ground conditions to be monitored at all times. During set up and once established, area to be maintained safe with adoption of cones, barrier tape and warning signage. If working in a public highway compliance with regards to New Street Work Act to be applied. No attempt is to be made to exceed safe working load or tamper with safety related devices.

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

• B10. Working in adverse weather conditions

  Yes

  No

• HARM - Falls from Height, serious injuries or death
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. All operations will cease in adverse weather conditions such as high winds, driving rain, thunder, lightning and snow or Ice

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• B11. Accessing a flat roof using MEWP

  Yes

  No

• HARM - Falls from Height, serious injuries or death
  PERSONS AT RISK - Operatives / Members of the public
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. MEWP must be operated by trained competent person. All areas below must be segregated from members of the public by means of signage and physical barriers. The MEWP arm must be fully extendable and be placed a suitable distance away from the edge of the roof. Suggest approx 2 meters. The operatives must be kept attached via a fixed lanyard at all times including exiting the basket until a safe distance can be maintained

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• RESIDUAL RISK - Low

FTTH Work

• Telecom specific hazards

  Yes

  No

• C1. Fibre termination - eye injury

  Yes

  No

• HARM - Eye injuries
  PERSONS AT RISK - Operatives/Members of the public
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. All operatives to ensure eye protection is worn whilst splicing fibres. Operatives who wear contact lenses must not handle their lenses until hands have been thoroughly washed.

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• C2. Fibre termination - Fibre contamination

  Yes

  No

• HARM - Fibres carried in clothing and contaminating other environments
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Disposable aprons to be worn during splicing activities

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• C3. Fibre termination - Fibre shards

  Yes

  No

• HARM - Shards of glass lodged in hands
  PERSONS AT RISK - Operatives / Members of the public
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. All operatives to ensure gloves are worn when tidying up following splicing. Use of a black mat to ensure fibres are caught and prevent release to local environment. Work areas to be cleared prior to leaving the site. All waste must be put in a suitable container for removal from site.

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• C4. Fibre termination - Ingestion

  Yes

  No

• HARM - Ingestion of fibre/Cross contamination of fibres
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Operatives must not eat, drink or smoke whilst carrying out splicing. Operatives will ensure that disposable aprons are worn whilst undertaking splicing work and that these are removed at the end of the task.

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• C5. Fibre termination - Fire

  Yes

  No

• HARM - Fire starting during fusion splicing activities
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Splicing activities MUST NOT take place in manhole covers due to the possible build up of flammable gases. All work will be undertaken in accordance with Chapter 8 of The New Roads and Streetworks Act 1991

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• C6. Cable - Manual Handling

  Yes

  No

• HARM - Manual handling injuries
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Operatives must receive manual handling training and implement principles while moving and handling cable, and setting up work areas. All removed cable to be placed on flatbed tipper to reduce manual handling for offloading.

• RESIDUAL RISK - Low

• Additional control measures required?

• Any Additional Control Measures Required?

• C9. Cable - Weill's Disease

  Yes

  No

• HARM - Zoonoses eg Weill's Disease
  PERSONS AT RISK - Operatives
  RISK RATING- High

• CONTROL MEASURES TO BE IMPLEMENTED -. Operatives may be working below ground or come into contact with vermin. Contact should be made with the Environmental Emergency Helpline 0800 807060. Operatives should not eat, drink or smoke whilst on site to minimise cross contamination. Correct washing techniques should be applied following work activities

• RESIDUAL RISK - Medium

• Additional control measures required?

• Any Additional Control Measures Required?

Photographs

• Block (all sides)

  Media

• Talk Talk node

  Media

• Existing cable

  Media

• Duct route

  Media

• Equipment locations

  Media

• Possible issues

  Media

Additional information

• Flat Number

• Toby Box number

• Distance to DP

• Flat Number

• Distance to DP

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• Distance to DP

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• Distance to DP

• Flat Number

• Distance to DP

• Flat Number

• Distance to DP

• Flat Number

• Distance to DP

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• Distance to DP

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• Distance to DP

• Flat Number

• Distance to DP

• Flat Number

• Distance to DP

• Flat Number

• Distance to DP

• Flat Number

• Distance to DP

• Flat Number

• Distance to DP

• Flat Number

• Distance to DP

• Flat Number

• Distance to DP

• Flat Number

• Distance to DP

• Flat Number

• Distance to DP

• Flat Number

• Distance to DP

• Flat Number

• Distance to DP

• Flat Number

• Distance to DP

• Flat Number

• Distance to DP

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• Distance to DP

• Flat Number

• Distance to DP

• Flat Number

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• Flat Number

• Distance to DP

• Flat Number

• Distance to DP

• Flat Number

• Distance to DP

Cable length totals (state number of lengths required)

• 10m

• 20m

• 30m

• 40m

• 50m

• 60m

• 70m

• 80m

Back Haul cable length

• Details of back haul cable length

Declaration

• I confirm that the information detailed in this survey is true and accurate and that the synthetics best match the scope of works.
  
  It is understood that any changes or alterations to any part of the design made by SCCI Alphatrack will need to be agreed by ourselves before any work commences.
  
  It is also understood that any changes or alterations to the scope of work required by us after the works have been completed may be met with additional charges and will be subject to a Re-Survey.
  
  

• Print Name

• Date

• Signed

  Sign