close
lumiform
LumiformMobile audits & inspections
Get AppGet App

Rope Access Risk Assessment Form

Rated 5/5 stars on Capterra

Say goodbye to paper checklists!

Lumiform enables you to conduct digital inspections via app easier than ever before
  • Cut inspection time by 50%
  • Uncover more issues and solve them 4x faster
  • Select from over 5,000 expert-proofed templates

Digitalize this paper form now

Register for free on lumiformapp.com and conduct inspections via our mobile app

  • Cut inspection time by 50%
  • Uncover more issues and solve them 4x faster
  • Select from over 4000 expert-proofed templates
Rated 5/5 stars on Capterra
App StorePlay Store

Rope Access Risk Assessment Form

Job Number

Job Type

Select date

Engineers on site

Is this a true SAT job?

If it is not SAT it is...

The following information constitutes an on-site risk assessment for the job. A Method Statement is also required.

Access to hight will be by:

Via Velux window or rooflight Sky SAT procedures with roped access techniques in use.

Ladder. With minimum control measures ( sky's fall arrest systems, eye bolting ML and LM or equivalent from the Ladder Hierarchy.

Via dormer Sky SAT procedures as trained with roped access techniques in use.

Other means ( give details below ) Specify minimum control measures required.

Additions to or variations from standard control measures. Any other relevant information- Please specify clearly.

Which (if any) ladders are to be used? Select all required. NOTE: All PPE and ladder hierarchy should be used as minimum control measure.

8 rung ladder

Single section

Double section

Triple section

DAT roof ladder

Extended DAT roof ladder (CAT extensions)

Combi ladder

If LM or ML cannot be used, state what alternative is to be used. An eyebolt or other attachment point must be used for all dish installs and all service work.

If anchor points are needed for Roped Access are they:

Existing and Fixed ( and in date and granted permission to use?)

Temporary - e.g. 20mm eyebolt (primary & back up?)

Part of the building structure- Checked and verified by both Engineers?

On-site identified hazards.

Can the following Hazards identified be removed. If hazard is not present select N/A

Adverse weather

Third parties

Existing equipment

Garden Hazards

Ground Hazards

Any other Hazard ( give details below)

Additional Hazard information

Can Hazards be controlled or minimised?

If Hazards cannot be controlled or minimised then they must be escalated (give details below)

Method Statement.

A clear and detailed method for carrying out the work must be recorded here before the work commences. Items to be covered include site details, pre job preparation, roof type (flat/sloping(give apps angles)); rescue considerations (if standard rescue techniques say so, otherwise specify in detail). The method statement should have sufficient detail to allow another SAT team to understand how they would carry out the work. Add photos/draw diagrams as necessary to illustrate.

Add media

Add drawing

Both engineers must sign before work commences.

SAT Engineer 1

SAT Engineer 2

Share this template: