For access to be granted, this form must be completed in full: Name Company Phone Email Sitename Cellreference Visit Details: Dateofvisit Timeofvisit Estimated time on site: Timeofvisit 1h 2h 3h 4h 5h 6h 7h 8h 9h 10h Scopeofworks Area to which access is required: Roof Roof Yes Structure Structure Yes Ground Ground Yes Other Other Yes OtherDetails Attendee Details: Name(s) of attendee(s Contact number of attendee(s Emergency contact (name and number) Please confirm which of the following certifications the attendee(s) hold and upload: 1. First Aid FirstAid Yes No FirstAidUpload 2. RF Awareness 2RF-Awareness Yes No RFUpload 3. Rooftop Rooftop_ Yes No RooftopUpload 4. Tower Climber Towerclimber_ Yes No TowerClimberUpload 5. Tower Rescue Towerrescue_ Yes No TowerRescueUpload 6. First Aid at height Firstaidatheight1 Yes No FirstAidHeightUpload Documents: Public Liability Insurance (essential) PLUpload Mobile Elevating Working Platform (if required) MEWP Risk Assessments and Method Statement (if required) Risk Assessments and Method Statements Additional Information: Additional info box Please note: By clicking submit, you hereby confirm that the attendees have valid certification as confirmed above. Attendees may be refused access if they cannot produce valid ID and their certification upon arrival to site. Once we have the required information, Amsy Chartered Surveyors will use all reasonable endeavours to respond to your request within 72 hours. In case of an emergency, please call us on 0161 211 5104. Submit
