JOB/SITE LOCATION

SUBMISSION COMPLETED BY

DATE

ADMINISTRATIVE

Give Yes or No

Contractor has read and understood Manor Group Contractor Commitment and Expectation Handbook

Contractor has completed and returned Manor Group Pre Work Application

SITE STAFF

All staff on site will be qualified and/or registered to perform their task(s)

PERSONAL PROTECTIVE EQUIPMENT

All PPE required will be worn and used correctly

PLANT AND EQUIPMENT

All plant and equipment being used will be in good working order and possess a current test tag.

WORKING FROM HEIGHTS

Will the job involve working from a height of 3 meters or more? If so what fall prevention measures will be in place? ( please list below)

Will the job require access or work from a ladder of more than 3 steps? If so, please detail below the prevention measures which will be in place.

SITE HAZARDS

All practicable steps have been taken to identify and minimise any onsite hazard(s). Work will not commence until this has occurred. List specific site hazards and the prevention measures in place below.