UK Sports Products - Risk Assessment & Site Visit

• Document Details:

• Client / Site:

• Address:

• Email:

• Telephone:

• Conducted On:

  Date

• Prepared By:

  Select J. Smith Shaun L. White

  • J. Smith
  • Shaun
  • L. White

RISK ASSESSMENT

• Are there identifiable hazards on site?

  Yes

  No

• Description of Hazards are scored in Worst Case Scenario:
  10 - Fatality
  8 - Sever Injury
  5 - Lost Time Injury
  3 - Minor Injury
  1 - No Injury
  
  The Risks are scored in Likelihood:
  10 - Certain/Imminent
  8 - Very Likely
  5 - Likely
  2- Unlikely
  1 - Remote

Hazard 01

• Location of Hazard 01:

• Description of Hazard 01:

• Worst Case Scenario:

  10 - Fatality

  8 - Severe Injury

  5 - Lost Time Injury

  3 - Minor Injury

  1 - No Injury

• Likelihood:

  10 - Certain/Imminent

  8 - Very Likely

  5 - Likely

  2 - Unlikely

  1 - Remote

• Control Measure in place:

• Are there any more Hazards?

  Yes

  No

Hazard 02:

• Location of Hazard 02:

• Description of Hazard 02:

• Worst Case Scenario:

  10 - Fatality

  8 - Severe Injury

  5 - Lost Time Injury

  3 - Minor Injury

  1 - No Injury

• Likelihood:

  10 - Certain/Imminent

  8 - Very Likely

  5 - Likely

  2 - Unlikely

  1 - Remote

• Control Measure in place:

• Are there any more Hazards?

  Yes

  No

Hazard 03:

• Location of Hazard 03:

• Description of Hazard 03:

• Worst Case Scenario:

  10 - Fatality

  8 - Severe Injury

  5 - Lost Time Injury

  3 - Minor Injury

  1 - No Injury

• Likelihood:

  10 - Certain/Imminent

  8 - Very Likely

  5 - Likely

  2 - Unlikely

  1 - Remote

• Control Measure in place:

• Are there any more Hazards?

  Yes

  No

• List additional Hazards in the following format:
  Hazard Number-Location-Description-Worst Case Scenario-Likelihood-Control Measure

Additional Hazards:

• Additional Hazards: (As per pre-mentioned format)

SITE VISIT

• Is a Site Visit required?

  Yes

  No

• Ideal Installation Date:

  Date

• Product/s Required:

  Select RecoveryTub Pro2 RecoveryTub Pro4 RecoveryTub ProX RecoveryTub Hydro

  • RecoveryTub Pro2
  • RecoveryTub Pro4
  • RecoveryTub ProX
  • RecoveryTub Hydro

RecoveryTub Pro2 Specifications

• Quantity Required:

• RecoveryTub Colour:

• Steps Colour:

RecoveryTub Pro4 Specifications

• Quantity Required:

• RecoveryTub Colour:

• Steps Colour:

RecoveryTub ProX Specifications

• Quantity Required:

• Steps Colour:

• Desired Length:

• Desired Width:

• Desired Depth:

• Required Features:

  Select Massage Wand Jets Air Loop

  • Massage Wand
  • Jets
  • Air Loop

RecoveryTub Hydro Specifications

• Quantity Required:

• Desired Length:

• Desired Width:

• Desired Depth:

• Required Features:

  Select Massage Wand Jets Air Loop Treadmill Anti-Swim Jet

  • Massage Wand
  • Jets
  • Air Loop
  • Treadmill
  • Anti-Swim Jet

• Treadmill Specifications:

  Select Standard Treadmill Team Treadmill

  • Standard Treadmill
  • Team Treadmill

• Quantity of Treadmills:

• Desired Length:

• Desired Width:

Building Information

• Is the building constructed?

  Yes

  Partially

  No

• Access to building for delivery vehicle with 8ft wide trailer?

  Yes, both

  No, delivery vehicle only

  No, neither

• Clear access into the desired room?

  Yes, fully

  Yes, some obstacles

  No, building works required

• Images of access route to desired room:

  Media

• Description of Obstacles: (steps, narrow hallway etc.)

• Images of obstacles:

  Media

• Images of access route to desired room:

  Media

• Description of Works Required: (removal of wall, window etc.)

• Images of obstacles:

  Media

• Images of access route to desired room:

  Media

Room Information

• Room Length:

• Room Width:

• Ceiling Height:

• Entrance Height: (door)

• Entrance Width: (door)

• Entrance Hallway Width:

• Entrance Hallway Height:

• Any ventilation?

  Yes

  No

• Type of Ventilation:

  Select Window/s Door/s Extractor Fan/Through Flow System Dehumidifier

  • Window/s
  • Door/s
  • Extractor Fan/Through Flow System
  • Dehumidifier

• Images of Ventilation:

  Media

Water Source:

• Water Source Available:

  Yes

  No

• Location of Water Source:

• Approximate distance of Water Source:

• Photos of Water Source:

  Media

Drainage:

• Drainage Available:

  Yes

  No

• Description of Drainage:

• Location of Drainage:

• Approximate distance of Drainage:

• Photos of Drainage:

  Media

Electrical Supply:

• Electrical Supply Available:

  Yes

  No

• Location of Electrical Supply:

• Approximate distance of Electrical Supply:

• Photos of Electrical Supply:

  Media

• Completion Date:

  Date

• Is the equipment being delivered before building is completed?

  Yes

  No

• Delivery Date:

  Date

Room Information

• Room Length:

• Room Width:

• Completion Date:

  Date

• Is the equipment being delivered before building is completed?

  Yes

  No

• Delivery Date:

  Date

Room Information

• Room Length:

• Room Width:

Additional Information:

• Any Additional Information:

• Any Additional Photos:

  Media