safety representative report form. - wordpress.com...2018/05/03  · electrical trunking uncovered....

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pg. 1 Safety Representative Report Form. Date of Inspection 03/05/2018 What is the Hazard? Level 3 Cleaners materials stored in toilets with corrosive chemicals and items stacked on top of cupboard. Female toilets have cleaning materials stored on chair under boiler. Carpet repairs worn. Shelves packed at high levels .

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Page 1: Safety Representative Report Form. - WordPress.com...2018/05/03  · Electrical trunking uncovered. Electrical device left open with wires exposed. Fire escapes not clearly labelled

pg. 1

Safety Representative Report Form.

Date of Inspection 03/05/2018

What is the Hazard? Level 3 Cleaners materials stored in toilets with corrosive chemicals and items stacked on top of cupboard. Female toilets have cleaning materials stored on chair under boiler.

Carpet repairs worn. Shelves packed at high levels

.

Page 2: Safety Representative Report Form. - WordPress.com...2018/05/03  · Electrical trunking uncovered. Electrical device left open with wires exposed. Fire escapes not clearly labelled

pg. 2

Electrical trunking uncovered. Electrical device left open with wires exposed.

Fire escapes not clearly labelled. Storage under desks. Fan heaters under desks. First Aid kits out of date. First Aid lists out of date. Copiers in same room as staff. Level 2 Female toilets whole in wall covered by duct tape. Ceiling trunking falling down.

Page 3: Safety Representative Report Form. - WordPress.com...2018/05/03  · Electrical trunking uncovered. Electrical device left open with wires exposed. Fire escapes not clearly labelled

pg. 3

Cables exposed

Carpet tiles loose.

Generals state of disrepair.

Page 4: Safety Representative Report Form. - WordPress.com...2018/05/03  · Electrical trunking uncovered. Electrical device left open with wires exposed. Fire escapes not clearly labelled

pg. 4

Lift without head height warnings.

Page 5: Safety Representative Report Form. - WordPress.com...2018/05/03  · Electrical trunking uncovered. Electrical device left open with wires exposed. Fire escapes not clearly labelled

pg. 5

Insufficient lighting by fire escape. Fire escape not marked. Fire escape signage leads you in continual loop. Ceilings damp and paint flaking.

Alarms and cabling hanging from ceilings/walls.

. Dangerous storage practices

Fire extinguishers locations not clearly marked.

Page 6: Safety Representative Report Form. - WordPress.com...2018/05/03  · Electrical trunking uncovered. Electrical device left open with wires exposed. Fire escapes not clearly labelled

pg. 6

Female toilets reported as not flushing properly. Hand trowels not replaced often enough. Windows are out of reach. Ground Level Blinds not working, replaced with paper (how did it get there?)

Page 7: Safety Representative Report Form. - WordPress.com...2018/05/03  · Electrical trunking uncovered. Electrical device left open with wires exposed. Fire escapes not clearly labelled

pg. 7

Rubbish in circulation spaces

Cables covered in packing tape.

Electrical cables and other dangers as per photos.

Page 8: Safety Representative Report Form. - WordPress.com...2018/05/03  · Electrical trunking uncovered. Electrical device left open with wires exposed. Fire escapes not clearly labelled

pg. 8

CONFIDENTIAL WAST LEFT ON FLOOR!

Page 9: Safety Representative Report Form. - WordPress.com...2018/05/03  · Electrical trunking uncovered. Electrical device left open with wires exposed. Fire escapes not clearly labelled

pg. 9

Cables loose in central service area.

More holes in more female toilets covered with duct tape and cleaning materials left on cupboard.

Page 10: Safety Representative Report Form. - WordPress.com...2018/05/03  · Electrical trunking uncovered. Electrical device left open with wires exposed. Fire escapes not clearly labelled

pg. 10

Fire manual out of date.

Front door does not always close properly. Lower level (Emergency HQ) Fire door propped open with brick

Page 11: Safety Representative Report Form. - WordPress.com...2018/05/03  · Electrical trunking uncovered. Electrical device left open with wires exposed. Fire escapes not clearly labelled

pg. 11

Flammable materials and cleaning materials stored in electrical service room.

Wall has hole in so fire protection is compromised. First aid materials 30 YEARS out of date.

Dead-leg pipe in kitchen.

Boiler drips. Broken glass on work surface.

Page 12: Safety Representative Report Form. - WordPress.com...2018/05/03  · Electrical trunking uncovered. Electrical device left open with wires exposed. Fire escapes not clearly labelled

pg. 12

Safety Reps Name: Lee Rhodes Date 03/05/2018

Record of receipt by the employers (representative).

Name (Print & Sign): Date:

To be completed by the employer:

Remedial Action taken (with date) or explanation if not taken. This information to be relayed to safety representative(s).

This report does not imply that the conditions are safe and healthy or that the arrangements for

welfare at work are satisfactory in all other respects.

Signature of employer or representative Date: