Cover Sheet

Sub-Contractors Weekly Health & Safety Returns

Site / Project Name: 8th Lock Contract Number: Week Ending: 11th August 2023

Asite Doc Reference 8THL-BALT-ZZ-ZZ-HS-X-22-0066 Purpose of Issue For Construction Authorisation Revision No C01

Sub-Contractor: Baltic

Manager: Daniel Crainet Supervisor: George Mare

This document must be submitted to the Ballymore Team weekly on a Friday by 12pm. The information provided above must be correct and reflect the current activities, plant,
equipment and operatives on site.
ITEM INSPECTION REQUIREMENT ATTACHED CONTRACTOR REQUIREMENTS COMMENT DATE
YES NO N/A
Toolbox Talks
✓ At least one TBT per week must be carried out to
all contractor operatives. Copies of the TBT
attendance register accompanied with the
document material used to carry out the TBT.

✓
Access Equipment Inspections Any equipment used for access to work at height -
podiums, hop-ups, etc

COSHH
✓ Register & COSHH data sheets required for all
hazardous materials on site
Site Managers Safety Audits/Reports
✓ Copies of weekly inspection reports must be
issued to Ballymore
Independent Safety Audits/Reports
✓ Copies of all Independent Safety inspection

✓
RAMS Updates/Briefings Any amendments to current RAMS to be
completed and evidence
provided including briefing sheets
Copies of Accident/Incident and Near Miss
Reports ✓ Copies of reports of any accidents and near
misses
Sub-Contractors Manager
Name: Daniel Crainet

Signature: Daniel

Date: 11/8/2023
 * Must specify details of any matters
GA3 - Report of Results of Inspections of: identified that could give rise to a
risk to the safety or health of any
Work Equipment for Work at a Height employee.

Name of person (or company) for whom the inspection was carried out: BALTIC DRYLINING

Address where inspection was carried out (site or other workplace): 8TH LOCK

Location & Name and

Signature
Description of Date and Results of position
Details of any corrective Details of any further ofperson
Equipment & any Time of Inspection*including ofperson
actions taken action necessary who made
Identification Inspectio defects & locations making
inspection
Numbers / n inspection
Marks
BG A-L 01 11/08/23 GOOD N/A N/A DANIEL DC
CRAINET

BG A-L 04 11/08/23 GOOD N/A N/A DANIEL DC

CRAINET

BG A-L 06 11/08/23 GOOD N/A N/A DANIEL DC

CRAINET

BG A-L 07 11/08/23 GOOD N/A N/A DANIEL DC

CRAINET

BG A-L 09 11/08/23 GOOD N/A N/A DANIEL DC

CRAINET

BG A-L 11 11/08/23 GOOD N/A N/A DANIEL DC

CRAINET
GA3 - Report of Results of Inspections of:
Work Equipment for Work at a Height
NOTES

This form may be used to assist in compliance with the Safety Health and Welfare at Work (General Application) Regulations 2007 Regulation 119 – Inspection
of Work Equipment in relation to scaffolds, guard-rails, toe-boards, barriers or similar means of protection, fixed and mobile working platforms, nets, airbags
or other collective safeguards for arresting falls, personal fall protection systems, work positioning systems, rope access and positioning techniques, fall
arrest systems, work restraint systems and ladders. This is not an approved or statutory form. Reports of Inspection may be produced in other formats. This
form does not substitute for reports of thorough examination of lifting equipment that may be required under other statutory provisions (see GA1 and GA2).

Safety, Health and Welfare at Work (General Application) Regulations, 2007 - Part 4 - Regulation 119

119. (1) An employer shall ensure that, as regards work equipment to which Regulations 101 to 114 apply—
(a) where the safety of the work equipment depends on how it is installed or assembled, it is not used after installation or assembly in any
position unless it has been inspected in that position,

(b) without prejudice to paragraphs (a) and (c), work equipment exposed to conditions causing deterioration which is liable to result in
dangerous situations is inspected—
(i) at suitable intervals, and
(ii) where exceptional circumstances have occurred that are liable to jeopardise the safety of the work equipment, as soon as
practicable following these exceptional circumstances, and

(c) without prejudice to paragraph (a), a working platform—

(i) used for construction work, and
(ii) from which an employee could fall 2 m or more, is not used in any position unless it has been inspected in that position within
the previous 7 days or, in the case of a mobile working platform, inspected on the site, within the previous 7 days.

(2) A person carrying out an inspection of work equipment to which paragraph (1)(c) applies shall—
(a) promptly prepare a report containing the particulars as set out in Schedule 5, and

(b) within 24 hours of completing the inspection, provide the report, or a copy thereof, to the person on whose behalf the inspection was
carried out.

(3) An employer receiving a report under paragraph (2) shall keep the report or a copy of the report—
(a) at the site where the inspection was carried out until the construction work is completed, and

(b) thereafter, at an office of the employer.

(4) An employer shall ensure that—

(a) no work equipment under the employer’s control is used in another place of work unless it is accompanied by evidence that the last
inspection required to be carried out under this Regulation has been carried out, and

(b) the result of an inspection under this Regulation is recorded and kept available for inspection by an inspector for 5 years from the date
of inspection.
 * Must specify details of any matters
GA3 - Report of Results of Inspections of: identified that could give rise to a
risk to the safety or health of any
Work Equipment for Work at a Height employee.

Name of person (or company) for whom the inspection was carried out: BALTIC DRYLINING

Address where inspection was carried out (site or other workplace): 8TH LOCK

Location & Name and

Results of Signature
Description of Date and position
Details of any Details of any ofperson
Equipment & any Time of Inspection*including ofperson
correctiveactions furtheraction who made
Identification Inspectio defects & locations making
taken necessary inspection
Numbers / n inspection
Marks
BG A-L 15 11/08/23 GOOD N/A N/A DANIEL DC
CRAINET

BG P-L 01 11/08/23 GOOD N/A N/A DANIEL DC

CRAINET

BG P-L 02 11/08/23 GOOD N/A N/A DANIEL DC

CRAINET

BG P-L 03 11/08/23 GOOD N/A N/A DANIEL DC

CRAINET

BG P-L 04 11/08/23 GOOD N/A N/A DANIEL DC

CRAINET

BG P-L 05 11/08/23 GOOD N/A N/A DANIEL DC

CRAINET
GA3 - Report of Results of Inspections of: NOTES
Work Equipment for Work at a Height

This form may be used to assist in compliance with the Safety Health and Welfare at Work (General Application) Regulations 2007 Regulation 119 – Inspection
of Work Equipment in relation to scaffolds, guard-rails, toe-boards, barriers or similar means of protection, fixed and mobile working platforms, nets, airbags
or other collective safeguards for arresting falls, personal fall protection systems, work positioning systems, rope access and positioning techniques, fall
arrest systems, work restraint systems and ladders. This is not an approved or statutory form. Reports of Inspection may be produced in other formats. This
form does not substitute for reports of thorough examination of lifting equipment that may be required under other statutory provisions (see GA1 and GA2).

Safety, Health and Welfare at Work (General Application) Regulations, 2007 - Part 4 - Regulation 119

119. (1) An employer shall ensure that, as regards work equipment to which Regulations 101 to 114 apply—
(a) where the safety of the work equipment depends on how it is installed or assembled, it is not used after installation or assembly in any
position unless it has been inspected in that position,

(b) without prejudice to paragraphs (a) and (c), work equipment exposed to conditions causing deterioration which is liable to result in
dangerous situations is inspected—
(i) at suitable intervals, and
(ii) where exceptional circumstances have occurred that are liable to jeopardise the safety of the work equipment, as soon as
practicable following these exceptional circumstances, and

(c) without prejudice to paragraph (a), a working platform—

(i) used for construction work, and
(ii) from which an employee could fall 2 m or more, is not used in any position unless it has been inspected in that position within
the previous 7 days or, in the case of a mobile working platform, inspected on the site, within the previous 7 days.

(5) A person carrying out an inspection of work equipment to which paragraph (1)(c) applies shall—
(a) promptly prepare a report containing the particulars as set out in Schedule 5, and

(b) within 24 hours of completing the inspection, provide the report, or a copy thereof, to the person on whose behalf the inspection was
carried out.

(6) An employer receiving a report under paragraph (2) shall keep the report or a copy of the report—
(a) at the site where the inspection was carried out until the construction work is completed, and

(b) thereafter, at an office of the employer.

(7) An employer shall ensure that—

(a) no work equipment under the employer’s control is used in another place of work unless it is accompanied by evidence that the last
inspection required to be carried out under this Regulation has been carried out, and

(b) the result of an inspection under this Regulation is recorded and kept available for inspection by an inspector for 5 years from the date
of inspection.
 * Must specify details of any matters
GA3 - Report of Results of Inspections of: identified that could give rise to a
risk to the safety or health of any
Work Equipment for Work at a Height employee.

Name of person (or company) for whom the inspection was carried out: BALTIC DRYLINING

Address where inspection was carried out (site or other workplace): 8TH LOCK

Location & Name and

Results of Signature
Description of Date and position
Details of any Details of any ofperson
Equipment & any Time of Inspection*including ofperson
correctiveactions furtheraction who made
Identification Inspectio defects & locations making
taken necessary inspection
Numbers / n inspection
Marks
BG P-L 06 11/08/23 GOOD N/A N/A DANIEL DC
CRAINET

BG ST 01 & 02 11/08/23 GOOD N/A N/A DANIEL DC

CRAINET

BG ST 03 & 04 11/08/23 GOOD N/A N/A DANIEL DC

CRAINET

BG ST 05 11/08/23 GOOD N/A N/A DANIEL DC

CRAINET

BG ST 06 11/08/23 GOOD N/A N/A DANIEL DC

CRAINET

BG ST 07 11/08/23 GOOD N/A N/A DANIEL DC

CRAINET
GA3 - Report of Results of Inspections of: NOTES
Work Equipment for Work at a Height

This form may be used to assist in compliance with the Safety Health and Welfare at Work (General Application) Regulations 2007 Regulation 119 – Inspection
of Work Equipment in relation to scaffolds, guard-rails, toe-boards, barriers or similar means of protection, fixed and mobile working platforms, nets, airbags
or other collective safeguards for arresting falls, personal fall protection systems, work positioning systems, rope access and positioning techniques, fall
arrest systems, work restraint systems and ladders. This is not an approved or statutory form. Reports of Inspection may be produced in other formats. This
form does not substitute for reports of thorough examination of lifting equipment that may be required under other statutory provisions (see GA1 and GA2).

Safety, Health and Welfare at Work (General Application) Regulations, 2007 - Part 4 - Regulation 119

119. (1) An employer shall ensure that, as regards work equipment to which Regulations 101 to 114 apply—
(a) where the safety of the work equipment depends on how it is installed or assembled, it is not used after installation or assembly in any
position unless it has been inspected in that position,

(b) without prejudice to paragraphs (a) and (c), work equipment exposed to conditions causing deterioration which is liable to result in
dangerous situations is inspected—
(i) at suitable intervals, and
(ii) where exceptional circumstances have occurred that are liable to jeopardise the safety of the work equipment, as soon as
practicable following these exceptional circumstances, and

(c) without prejudice to paragraph (a), a working platform—

(i) used for construction work, and
(ii) from which an employee could fall 2 m or more, is not used in any position unless it has been inspected in that position within
the previous 7 days or, in the case of a mobile working platform, inspected on the site, within the previous 7 days.

(8) A person carrying out an inspection of work equipment to which paragraph (1)(c) applies shall—
(a) promptly prepare a report containing the particulars as set out in Schedule 5, and

(b) within 24 hours of completing the inspection, provide the report, or a copy thereof, to the person on whose behalf the inspection was
carried out.

(9) An employer receiving a report under paragraph (2) shall keep the report or a copy of the report—
(a) at the site where the inspection was carried out until the construction work is completed, and

(b) thereafter, at an office of the employer.

(10) An employer shall ensure that—

(a) no work equipment under the employer’s control is used in another place of work unless it is accompanied by evidence that the last
inspection required to be carried out under this Regulation has been carried out, and

(b) the result of an inspection under this Regulation is recorded and kept available for inspection by an inspector for 5 years from the date
of inspection.
 * Must specify details of any matters
GA3 - Report of Results of Inspections of: identified that could give rise to a
risk to the safety or health of any
Work Equipment for Work at a Height employee.

Name of person (or company) for whom the inspection was carried out: BALTIC DRYLINING

Address where inspection was carried out (site or other workplace): 8TH LOCK

Location & Name and

Results of Inspection* Signature of
Description of Date and position of
Details of any corrective Details of any further person who
Equipment & any Time of including defects & person
actions taken action necessary made
Identification Inspection locations making
inspection
Numbers / Marks inspection
BG ST 08 & 09 11/08/23 GOOD N/A N/A DANIEL DC
CRAINET

BG ST 10 11/08/23 GOOD N/A N/A DANIEL DC

CRAINET

BG MT 01 & 02 11/08/23 GOOD N/A N/A DANIEL DC

CRAINET
GA3 - Report of Results of Inspections of: NOTES
Work Equipment for Work at a Height

This form may be used to assist in compliance with the Safety Health and Welfare at Work (General Application) Regulations 2007 Regulation 119 – Inspection
of Work Equipment in relation to scaffolds, guard-rails, toe-boards, barriers or similar means of protection, fixed and mobile working platforms, nets, airbags
or other collective safeguards for arresting falls, personal fall protection systems, work positioning systems, rope access and positioning techniques, fall
arrest systems, work restraint systems and ladders. This is not an approved or statutory form. Reports of Inspection may be produced in other formats. This
form does not substitute for reports of thorough examination of lifting equipment that may be required under other statutory provisions (see GA1 and GA2).

Safety, Health and Welfare at Work (General Application) Regulations, 2007 - Part 4 - Regulation 119

119. (1) An employer shall ensure that, as regards work equipment to which Regulations 101 to 114 apply—
(a) where the safety of the work equipment depends on how it is installed or assembled, it is not used after installation or assembly in any
position unless it has been inspected in that position,

(b) without prejudice to paragraphs (a) and (c), work equipment exposed to conditions causing deterioration which is liable to result in
dangerous situations is inspected—
(i) at suitable intervals, and
(ii) where exceptional circumstances have occurred that are liable to jeopardise the safety of the work equipment, as soon as
practicable following these exceptional circumstances, and

(c) without prejudice to paragraph (a), a working platform—

(i) used for construction work, and
(ii) from which an employee could fall 2 m or more, is not used in any position unless it has been inspected in that position within
the previous 7 days or, in the case of a mobile working platform, inspected on the site, within the previous 7 days.

(11) A person carrying out an inspection of work equipment to which paragraph (1)(c) applies shall—
(a) promptly prepare a report containing the particulars as set out in Schedule 5, and

(b) within 24 hours of completing the inspection, provide the report, or a copy thereof, to the person on whose behalf the inspection was
carried out.

(12) An employer receiving a report under paragraph (2) shall keep the report or a copy of the report—
(a) at the site where the inspection was carried out until the construction work is completed, and

(b) thereafter, at an office of the employer.

(13) An employer shall ensure that—

(a) no work equipment under the employer’s control is used in another place of work unless it is accompanied by evidence that the last
inspection required to be carried out under this Regulation has been carried out, and

(b) the result of an inspection under this Regulation is recorded and kept available for inspection by an inspector for 5 years from the date
of inspection.
 Contractor Equipment Type Equipment ID Certificate
Baltic Drylining Stilts B.G. ST. 01 Good
Baltic Drylining Stilts B.G. ST. 02 Good
Baltic Drylining Stilts B.G. ST. 03 Good
Baltic Drylining Stilts B.G. ST. 04 Good
Baltic Drylining Stilts B.G. ST. 05 Good
Baltic Drylining Stilts B.G. ST. 06 Good
Baltic Drylining Stilts B.G. ST. 07 Good
Baltic Drylining Stilts B.G. ST. 08 Good
Baltic Drylining Stilts B.G. ST. 09 Good
Baltic Drylining Stilts B.G. ST. 10 Good
Baltic Drylining Mobile Tower B.G. M.T. 01 Good
Baltic Drylining Mobile Tower B.G. M.T. 02 Good
Baltic Drylining Podium Ladder B.G. PL 01 Good
Baltic Drylining Podium Ladder B.G. PL 02 Good
Baltic Drylining Podium Ladder B.G. PL 03 Good
Baltic Drylining Podium Ladder B.G. PL 04 Good
Baltic Drylining Podium Ladder B.G. PL 05 Good
Baltic Drylining Podium Ladder B.G. PL 06 Good
Baltic Drylining A Ladder B.G. L. 01 Good
Baltic Drylining A Ladder B.G. L. 04 Good
Baltic Drylining A Ladder B.G. L. 06 Good
Baltic Drylining A Ladder B.G. L. 07 Good
Baltic Drylining A Ladder B.G. L. 09 Good
Baltic Drylining A Ladder B.G. L. 11 Good
Baltic Drylining A Ladder B.G. L. 15 Good
INTEGRATED RISK SOLUTIONS
Consulting engineers specializing in safety and environment

Stilts Permit (Form Number 34)

Company Name: Baltic
Exact Work Location: Multiple Levels Block A & B
Supervisor Name: Daniel Crainet
Stilt Worker Name(s): Vasile / Anton / Florin / Gabriel Ghiuzan / Gabriel Bacaoanu

Yes No
• Floor surfaces are solid and level?
✓ □
• Floor surfaces are cleared of building materials, swept and dry?
✓ □
• Electric extension leads and cables are clear of the work area?
✓ □
• Floor penetrations are securely covered?
✓ □
• Stilt works are the only works underway in the immediate work area?
✓ □
• Workers (besides workers assisting the stilt worker) are excluded from
the work areas by barricading/taping off? ✓ □
• Stilt workers are competent in the use of stilts? ✓ □
•The stilts have been visually checked prior to mounting and are in good
condition and there is a suitable, rigid mounting/dismounting platform?
✓ □
Comments:

I confirm that the work area is now safe to commence stilt works.

Signed: George Date: 11th August 2023

Sub-contractor Foreman

Witnessed: Daniel Date: 11th August

2023Site Management