DRAFT - Window Cleaning Site Survey

Client Name:

AFG Number:

Site:

Surveyor Name:

Date:

Description of works:

Approx no of internal window panes:

Approx no of external window panes:

Estimated size of internal clean:

Small

Medium

Large

Estimated size of external clean:

Small

Medium

Large

No of floors / storeys Internal:

No of floors / storeys External:

Complexity of internal clean:

Easy

Medium

Large

Complexity of external clean:

Easy

Medium

Hard

Man hours required, internal clean:

Man hours required, external clean:

Total No. days to complete job in & out:

Total No. operatives to complete job in & out:

MEWP required Yes/No:

If yes, total No of the above hours requiring a MEWP:

Work at height required? Give details:

General Comments/ Diagram:

1.1 Will it be necessary to carry out any part of the job from a ladder?

Yes

No

If yes to the above, give locations & details below:

If yes to the requirement for ladders, upload photos of area's here:

Please insert a Page Break before this question.

If yes to 1.1, can this task be avoided? Either using a pole from the ground, or elimination of the task through conditional survey?

yes

No

If no, Please explain

If working from a ladder can not be avoided, is it reasonably practicable to carry out this work using a MEWP instead?

Comments - i.e.(cost/time/trouble/effort v Risk/likelihood/severity)

Is the ladder work of short and light duration? Less than 20 minutes.

Yes

No

Give details to question above

Will the ladder work involve awkward lifting of equipment, or overreaching?

Yes

No

Give details to question above

Can the ladder be tied at the top and bottom? If no, can a second operative be available to foot the ladder at all times?

Yes

No

Give details to question above

Can the ladders be set on firm and level ground?

Yes

No

Give details to question above

Will it be necessary to carry out any part of the job from a flat roof?

Yes

No

Give details to question above - i.e locations and photos for reference