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Forms

This page contains the Estates & Facilities Health and Safety forms.

Forms Description
Access Equipment Site Survey (doc, 46KB) Supervisors to complete to select access equipment for Work at Height

Request asbestos information

Once logged into Estates and Facilities ServiceNow, choose Forms, Asbestos to request Asbestos sampling/ survey/ report
Blank Risk Assessment Form (pdf, 191KB) For standard task risk assessments and to aid supervisors develop job specific risk assessments
Contractors - Access Authorisation (dotx, 31KB) To be completed by EFD Representative to allow access to restricted areas of the University
Contractors - Area Decontamination Certificate (pdf, 43KB) To be completed by the Responsible Person for lab to confirm the area has been decontaminated before works start
Contractors - Clearance to Work Certificate (pdf, 155KB) To be completed by the Responsible Person for lab to confirm the area is safe to work in and highlight any additional control measures
Contractors - Management of Contractors Checklist EFD Rep (dotx, 45KB) To be completed by EFD Representative before and after contractor works
Contractors - Documentation Appraisal Sheet (dotx, 38KB) Recommended to be completed by EFD Representatives to appraise contractor documentation
Contractors - Construction Induction Record (dotx, 42KB) To be complete by each operative after a site induction
Contractors - Site Inspection Checklist (docx, 51KB) To be completed when there is a discreet site, frequency to be agreed before works begin
Contractors - Site Set-up (dotx, 36KB) To be completed when there is a discreet site, before works begin to confirm contractors site complies with University minimum standards
Electrical Change of Status Certificate (pdf, 153KB) To be completed when an isolation is required
Identifying Confined Spaces Checklist (doc, 47KB) Supervisor/ Project Managers to complete to identify Confined Spaces
Incident- Investigation Form (doc, 91KB) For Managers/ Health, Safety and Wellbeing to complete
Incident- Injured Person/ Witness Statement (doc, 86KB) To be completed by injured person or witness following an accident/ incident
Incident- Report an accident/ incident Report an accident, incident or near miss
Ladder Site Survey (doc, 44KB) Operatives to complete before using a ladder
Ladder Inspection Checklist (doc, 37KB) Supervisors to complete on inspecting ladders
MAC - Manual Handling Task Score Sheet (pdf, 154KB) To be completed in association with HSE guidance INDG 383
Manual Handling Point of Work Risk Assessment (doc, 52KB) To be completed for Manual Handling Tasks that the Standard Task Risk Assessment does not cover
MEWP Site Survey (doc, 50KB) Operative to complete before using MEWP (Nifty Lift)
Mobile Tower Scaffold Site Survey (doc, 46KB) Operative to complete before erecting a Mobile Tower
Point of Work Risk Assessment Form (doc, 60KB) Supervisor to complete before works if necessary
Record of Issue of PPE (pdf, 102KB) Supervisor to complete to record PPE issued to operatives
Safety Tour Form (doc, 69KB) Senior Management to complete to record safety tours carried out
Scaffolding Inspection Checklist (pdf, 160KB) To be completed by competent scaffolding inspector for basic scaffolds
Stepladder Site Survey (doc, 44KB) Operative to complete before using stepladders