Title Page

  • Cluster ID/ Project:

  • Location:
  • Inspection Date:

  • Inspected By:

  • Workers/ Subcontractors Inspected:

SAFETY:

  • Work pack or task instruction is readily accessible, on site and up to date with information?

  • Workers are wearing the appropriate Personal Protective Equipment (PPE) including but not limited to steel cap boots, full hi-vis clothing, safety glasses, gloves and hard hat?

  • Specialist PPE is being used appropriately and according to hazardous task and SHEWMS (ie: Working in confined spaces)?

  • PPE is fit for purpose and in good condition?

  • All workers are trained on how to use PPE?

  • Materials in vehicles are stored adequately?

  • Site and/or pathways clear of slip / trip hazards?

  • Has the risk assessment been filled in correctly? Have you signed on as a visitor and been made aware of additional hazards on site?

INDUCTIONS

Induction Training / Certificates

  • Have all persons on site undertaken the appropriate induction training?

  • Are personnel appropriately qualified and competent? Do they have their NOPS cards?

SECURITY

Site Security & Public Protection

  • Is the site secure from entry by members of the public?

  • Are movements of people on and off site controlled?

  • Is task lighting sufficient when working in low light?

  • Do pedestrians have safe passage?

  • Please upload any additional hazards to site security?

WORKING AT HEIGHT

Working at Heights

  • Are all fall hazards identified and controls in place?

  • Is SLG in place to increase site presence whilst working at height?

  • Are all personnel required to work at heights trained and competent to do so?

  • Is there a rescue plan in place and operatives aware of the procedure in case of an incident or accident?

  • Are there exclusion zones established around any work at height? And have these been identified prior to works commencing?

  • For pole work, has the pole been tested and pre climb label installed?

  • Harnesses, lanyards and other fall arrest equipment have been inspected prior to use in accordance with RAMS?

  • Has a drop zone been established around the working area?

  • Has the drop zone area been correctly guarded and controlled?

  • Do pedestrians have safe passage in proximity to the identified drop zone?

  • Please upload any additional hazards to the working area?(i.e. windows, flue, balconies, air conditioning unit?)

LADDER CHECKS

Ladders

  • Ladders inspected and in good condition?

  • Ladders properly secured top and bottom?

  • Is the ladder deployed within its 4:1 ratio?

  • L7EQ 3 Stage Fiberglass ladder in use?

  • Have the ladders been tagged with the relevant inspection information?

  • Have additional ladder support systems been implemented where practicable? i.e.(ladder mats, TETRA, URAT)

EMERGENCY MANAGEMENT

Emergency Management

  • Telephone numbers and locations of nearby hospitals are available and known?

  • Evacuation point is established, in a safe location and known to workers?

  • Are there a sufficient number of trained first-aid staff on-site?

  • Are a sufficient number of first aid kits available and are they properly stocked?

  • Are operatives familiar with MDU emergency procedures? (i.e. Fire exits, Alarms, Fire Extinguishers?)

MEWP INFORMATION

MEWP

  • Is MEWP in date for its LOLER inspection?

  • Has the MEWP pre-use inspection report been filled in and signed by operative?

  • Are the operatives aware and signed the IPAF emergency rescue plan?

  • All outriggers are deployed on firm surface / supported as per manufacturers’ and is the boom protected from traffic? Is SLG sufficient for the scope of works?

  • HotJobs identified when working in vicinity of HV? Correct exclusion zone in place?

  • Is the operative clipped onto the strongpoint in the bucket with fall restraint lanyard?

  • All warning and information signs visible on the vehicle?

  • All equipment properly lubricated and maintained?

  • Bucket clear of any debris and tools?

  • Are the outriggers deployed on base plates to avoid damage to existing infrastructure?

  • Please add any additional photos regarding the MEWP:

QUALITY OF WORKS

Quality

  • Has the work been completed to the required standards?

  • Please provide additional photos of installation works:

FIRE AWARENESS

Fire Prevention

  • Portable Fire Fighting Equipment in vehicles?

  • Training in Fire Fighting procedures?

VEHICLE INFORMATION

MOTOR VEHICLES

  • Regular inspections and maintenance carried out?

  • All personnel are appropriately licensed?

  • Brakes, lights and warning devices operative?

  • Weight limits and load sizes controlled/ stored correctly?

  • Glass in good condition?

  • Parking of vehicles observed correctly?

  • Has the vehicle defect log been filled in prior to driving the vehicle? Have all defects been logged and supervisor made aware?

  • Please upload pictures of any defects regarding the vehicles:

TRAFFIC MANAGEMENT

TM

  • Is TM required on site for the scope of the work?

  • Traffic management signs, including speed restriction and advanced warning signage is legible and positioned in accordance with plans and Regulations?

  • Are traffic control measures maintained by an accredited traffic controller?

  • Are there sufficient Traffic Management operatives to control the site?

  • Traffic management company is accredited with the relevant authority?

  • Traffic management controls offer adequate protection to workers and the public?

  • Please upload any additional photos relating to TM:

WORKING IN THE HEAT

Working In Hot Conditions

  • There are adequate amounts of water on site to drink?

  • Workers have the appropriate PPE + Sunscreen?

  • There are adequate places for operatives to rest in the shade?

  • Work / rest ratios are adequate to allow workers to recuperate in extreme heat?

WORKING IN THE COLD

Working In The Cold

  • There is adequate clothing available for the conditions?

  • There is the availability of shelter with adequate heating?

ISOLATED LOCATIONS

Isolated Working

  • There is adequate communication available on site?

  • Emergency procedure understood? Use of W3W?

  • Food and water available for the duration of task?

  • Supervisor check in procedure? Communication to management observed?

WELFARE

Welfare

  • Do you have adequate food and water?

  • Do you know where the nearest toilet facility is located?

  • Do you have an adequate cleaning facility or cleaning materials to ensure you can clean yourself on completion of works?

WASTE MANAGEMENT

Waste Management

  • Bins are available for work site waste, recycled material, scrap, etc.?

  • All site areas are kept tidy with litter removed from site and disposed of appropriately?

  • Prescribed waste (contaminated water/soil, sharps), oils and greases and associated containers are being disposed of appropriately?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.