F10 Form – Fill Out and Use This PDF

Health and Safety

Executive

Notification of construction project

The Data Protection Act 1998 required the Health and Safety Executive (HSE) to inform you that this form may include information about you (this is called 'personal data' in the Act) and that we are a 'data controller' for the purposes of this Act. HSE will process these data for health, safety and environmental purposes. HSE may disclose these data to any person or organisation for the purpose for which it was collected or where the Act allows disclosure. As data subject, you have the right to ask for a copy of the data and to ask for any inaccurate data to be corrected.

1. Guidance notes for completion - Please complete in block capitals using black ink

What should this form be used for

•To notify the enforcing authority for the Construction (Design and Management) Regulations 2007 of any project that is likely to last longer than 30 days or involve more than 500 person days of construction work.

•Any day on which construction work is carried out (including holidays and weekends) should be counted, even if the work on that day is of short duration.

•A person day is one individual, including supervisors and specialists, carrying out construction work for one normal working shift.

•Construction work for a domestic client is not notifiable.

Who should use this form

•The CDM co-ordinator for the project.

Where to send the completed form

•F10 Scanning Centre, Health and Safety Executive, c/o Central Despatch, Redgrave Court, Merton Road, Bootle, Merseyside L20 7HS.

•If the notifiable work is on an operation railway, the notification should be sent to the Office of Rail Regulation. You can get the address by contacting HSE's Infoline, Tel: 0845 345 0055.

When to send this form

•As soon as practicable after the CDM co-ordinator for the project is appointed by the client.

2.Notification type

Is this the initial notification of the project or are you providing additional information not previously available?

Initial Notification

Additional Information

3. Date of forwarding this notification or provision of additional information?

- -

4.Name of the Local Authority where the site is located

5.Address of the construction site (Mandatory fields are marked with an asterisk(*))

Are there multiple construction sites

Yes

No (Please give the main address below)

Address

Name

Street*

District

Town*

County

Country*

England

Wales

Scotland

Postcode*

F10 (04.08)

64431

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Executive

6 a. Project type - IMPORTANT: Please select ONE checkbox only from this page

For mixed projects please tick the box that reflects the primary element of the work. Additional information may be provided on the following page in section 6 b.

		Not Required		Asbestos		Building Services		Utilities Work
		Painting&Decorating		Road & Path		Site Investigation		Telecomm. Towers
		Tunnel		Water Project		Other

Demolition/Dismantling

		House		Factory		Chimney		Railways
		Other
Mechanical & Electrical (M & E)
		Installation		Repair
Roofwork Repair
		Residential		Commercial		Other
Groundworks
		Piling		Tunnelling		Underpinning		Other
New Build - Civil Engineering
		Bridge		Road		Waterway		Docks
		New Build - Railways				New Build - Other
New Build - Commercial Premises
		Shop		Warehouse		Factory		Other
New Build - Residential Premises
		Houses 0 - 5		Houses 5 - 10		Houses 10 - 20		Houses > 20
		Flats 0 - 5 storey		Flats 5 - 10 storey		Flats 10 - 20 storey		Flats > 20 storey
		Other
Refurbishment (including Repair & Redecoration)
		Commercial		Residential		Railway		Other
Refurbishment (including Repair & Redecoration) - Civil Engineering
		Bridge		Road		Waterway		Docks
		Other

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6 b. Please provide a brief description of the project and the construction work it includes *

IMPORTANT: You MUST complete the CDM Co-ordinator details.

Mandatory fields, marked with an asterisk (*), must be completed for every contact provided.

7. CDM co-ordinator contact details

Name*

Address

Name

Street*

District

Town*

County

Country*

England

Wales

Scotland

Postcode*

Telephone

Email

Address*

8. Principal contractor contact details

Name*

Address

Name

Street*

District

Town*

County

Country*

England

Wales

Scotland

Postcode*

Telephone

Email

Address

64431

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9. Client contact details

Name*

Address

Name

Street*

District

Town*

County

Country*		England		Wales		Scotland	Postcode*

Telephone

Email

Address

10. Name and address of any designers already engaged

Name*

Address

Name

Street*

District

Town*

County

Country*		England		Wales		Scotland	Postcode*

Telephone

Email

Address

11. Name and address of any contractors already appointed

Name*

Address

Name

Street*

District

Town*

County

Country*

England

Wales

Scotland

Postcode*

Telephone

Email

Address

64431

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