Visitors Covid Self-Declaration
| Date of Visit | Your Name | Phone Number | Who Are You | Name Of Company | Medical Q1 | Medical Q2 | Medical Q3 | Medical Q4 | Medical Q5 | Medical Q6 | Signature |
|---|---|---|---|---|---|---|---|---|---|---|---|
| YES | NO | NO | NO | NO | NO | ||||||
| YES | NO | NO | NO | NO | NO | ||||||
| January 12, 2021 | Steve Cresswell | 07425880003 | I am a Visitor to Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| January 12, 2021 | Steve Cresswell | 07425880003 | I am a Visitor to Electrification Construction Services Ltd (ECS) | Speedy | NO | NO | NO | NO | NO | NO |  |
| January 12, 2021 | Graham carney | 07976713806 | I am a Visitor to Electrification Construction Services Ltd (ECS) | G carney | NO | NO | NO | NO | NO | NO |  |
| January 12, 2021 | Graham carney | 07976713806 | I am a Visitor to Electrification Construction Services Ltd (ECS) | G carney | NO | NO | NO | NO | NO | NO |  |
| January 13, 2021 | Steve Cresswell | 07425880003 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| January 13, 2021 | Jonathan Dixon | 07884480357 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| January 13, 2021 | Ray matthews | 07487886803 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| January 13, 2021 | Heath Martin | 07791565699 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| January 14, 2021 | Jonathan Dixon | 07884480357 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| January 14, 2021 | Louise parrish | 0774898352 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| January 15, 2021 | Jonathan Dixon | 07884480357 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| January 15, 2021 | Heath martin | 07932812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| January 18, 2021 | Heath Martin | 07791565699 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| January 22, 2021 | Heath Martin | 07791565699 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| January 22, 2021 | Andy Buckley | 07512195893 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| January 13, 2021 | Heath Martin | 07791565699 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| January 25, 2021 | Heath Martin | 07932812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| January 18, 2021 | Heath Martin | 07791565699 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| January 15, 2021 | Heath martin | 07932812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| January 28, 2021 | Jonathan Dixon | 07884480357 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| January 29, 2021 | Heath Martin | 07932812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| January 29, 2021 | Steve Cresswell | 07425880003 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| January 29, 2021 | Jonathan Dixon | 07884480357 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| January 29, 2021 | Heath Martin | 07932812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| February 1, 2021 | Heath Martin | 07912812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| February 1, 2021 | Steve Cresswell | 07425880003 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| February 2, 2021 | Jonathan Dixon | 07884480357 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| February 2, 2021 | Paul Connor | 07703792008 | I am a Visitor to Electrification Construction Services Ltd (ECS) | Cembre | NO | NO | NO | NO | NO | NO |  |
| February 2, 2021 | Steve Cresswell | 07425880003 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| February 8, 2021 | Heath Martin | 07932812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| February 12, 2021 | Heath Martin | 07912812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| February 15, 2021 | Heath Martin | 07912812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| February 16, 2021 | Peter Edwards | 07485084995 | I am a Visitor to Electrification Construction Services Ltd (ECS) | WEST WALLASEY | NO | NO | NO | NO | NO | NO |  |
| February 26, 2021 | Heath Martin | 07932812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
|
| March 4, 2021 | Timothy Day | 07920460204 | I am a Visitor to Electrification Construction Services Ltd (ECS) | Dday training ltd | NO | NO | NO | NO | NO | NO |  |
| March 5, 2021 | Heath Martin | 07932812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| March 5, 2021 | Jonathan Dixon | 07884480357 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| March 5, 2021 | Steve Cresswell | 07425880003 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| March 5, 2021 | James Fuller | 07860680973 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| March 8, 2021 | James Fuller | 07960680973 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| March 12, 2021 | Heath Martin | 07932812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| March 17, 2021 | Heath Martin | 07932812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| March 18, 2021 | James Fuller | 07976687973 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| March 19, 2021 | Heath Martin | 07932812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| March 19, 2021 | Heath Martin | 07932812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| March 17, 2021 | Heath Martin | 07932812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| March 12, 2021 | Heath Martin | 07932812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| March 5, 2021 | Heath Martin | 07932812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| February 26, 2021 | Heath Martin | 07932812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| February 15, 2021 | Heath Martin | 07912812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| February 12, 2021 | Heath Martin | 07912812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| February 8, 2021 | Heath Martin | 07932812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| February 1, 2021 | Heath Martin | 07912812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| January 29, 2021 | Heath Martin | 07932812504 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
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| May 4, 2021 | Johnbrampton | 07703737969 | I am a Visitor to Electrification Construction Services Ltd (ECS) | Twi | NO | NO | NO | NO | NO | NO |  |
| March 7, 2022 | Stephen Cresswell | 07425880003 | I work for Electrification Construction Services Ltd (ECS) | NO | NO | NO | NO | NO | NO |  |
