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• Depot Prefix. *A= AnglseyBI= BicesterB= BlandfordBR= BridgwaterJ= CarmarthenCH= ChippenhamE= DroitwichES= EssexG= GwentHE= HerefordK= KentLE= LeedsNL= London NorthSL= London SouthLL=LlanidloesLl= LincolnM= ManchesterME= MerseysideNA= NantwichN= NottinghamNU= NuneatonP= PaigntonPE= PeterboroughPO= PortsmouthMI=MiddlesboroughS= SwanseaZ= TelfordT= TruroW= WrexhamDepot Prefix. *
• Select Depot for email purposeAngleseyBicesterBlandfordBridgwaterCarmarthenChippenhamDroitwichEssexGwentHerefordKentLeedsLondon NorthLondon SouthLlanidloesLincolnManchesterMerseysideNantwichNottinghamNuneatonPaigntonPeterboroughPortsmouthMiddlesboroughSwanseaTelfordTruroWrexhamSelect Depot for email purpose *
• Customer
• Section 1. Site Details
• Planned duration of works:
• Job description *
• Road Speed *20 mph30 mph40 mph50 mph60 mphNational SpeedRoad Speed *
• Local Authority:
• Method statement used *
• TM CAD plan used ref number:
• Grade: *TMOLTMOTSCOGrade: *
• Vehicle Type *Flatbed With Tail-liftFlatbedIPVPanel VanVehicle Type *
• Vehicle Registration(s) *
• Above completed by: *
• Position:
• The spervisor for this works:
• Section 2. Ped consideration *

  Pedestrian F/W in place

  Is existing safe to use

  Site need ped management

  If no proceed nxt section

  Is there min 1m clearance

  Proposed plan see pics.
• Section 3. *

  Near pedestrian crossing

  Near Schools

  near permanent signals

  Near roundabouts

  Near railway crossings

  Near shops

  Near Entrance Exits

  Near Parked Cars

  Near Trees

  Near or on a bridge

  Bus or Tourist route

  Road Juntions
• Weather conditions *WetDrySunnyCloudyFoggyIcyWeather conditions *
• Traffic counts Per Hour *
• Line of sight visibility? *GoodAcceptablePoorLine of sight visibility? *
• Day or Night operations? *DayNightDay or Night operations? *
• Additional comments.
• Min sideways safety zone req *0.5m1.2mN/AMin sideways safety zone req *
• Min Longways safety zone req *0.5m15m30m60mN/AMin Longways safety zone req *
• Safety zone delineated *With conesWith cones safety tapeWith Ped BarrierN/ASafety zone delineated *
• Max site length allowed *50m100m200m300m400m500mN/AMax site length allowed *
• Minimum running width req *2.5m3.0m3.25m5.5m6.75mN/AMinimum running width req *
• HGV / Bus route? *YesNoHGV / Bus route? *
• Sideways safety zone in place? *YesNoSideways safety zone in place? *
• Longways safety zone in place? *YesNoLongways safety zone in place? *
• Actual site length? *
• Running width in place? *YesNoRunning width in place? *
• Handed over to client customer *YesNoHanded over to client customer *
• Overall level of risk? *HIGH - add notesMedium - add notesLowOverall level of risk? *
• Site photos *

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• Latitude, Longitude
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