RISK ASSESSMENT & METHOD STATEMENT Example 1

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RISK ASSESSMENT & METHOD STATEMENT Example 1 Customer Another Limited Site Any town House, Any town, A123 4ZX Contact Name(s) Andy Person Customer Order No. Example 4 No. of pages 17 Description of work Stables plant room heating efficiency project Date Issued Thursday 28th October 2010 Date(s) of Work Works commencing Monday 1st November 2010 Please find METHOD STATEMENT & Risk ASSESSMENT herewith for the above works. A copy of this document will be available on site with the nominated ECEX Supervisor at all times. Please confirm your acceptance by signing below and returning this page to us by fax / email (scan) today. If there are any risks which ECEX have not covered then please let us know as soon as feasibly possible to eliminate all potential hazards. (NB: We cannot work on site without your acknowledgment). Surveyed by: A Safety Person Risk ASSESSMENT and METHOD STATEMENT completed by: A Safety Person Approved by: A Manager Best Regards ECEX A Manager I confirm our acceptance of this Risk ASSESSMENT & METHOD STATEMENT and that we will undertake our responsibilities as listed on Page 2 Signature Print Name On behalf of (Company) Date Page 2 of 19 MSRA Client responsibilities: Please confirm that the following are/will be in place to avoid delays / aborted visits and consequential additional costs Request # Request details To be completed when?

Provide parking for vehicle registration numbers 1, 2, 3 (initial project phases) – others TBC for next phase of works Upon ECEX arrival at site 4. ... All services to the boiler room to be phased isolated and physically disconnected including the gas, water, electrics and data h. Drain down and vent the system

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