SITE / JOB DETAILS
Date of inspection
Date
GANG
Select
msn 1
msn 2
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msn 4
msn 5
msn 6
msn 7
msn 8
msn 9
msn 10
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msn 12
msn 1 msn 2 msn 3 msn 4 msn 5 msn 6 msn 7 msn 8 msn 9 msn 10 msn 11 msn 12
Vehicle registration Number
Address
Address
Location
County
Select
Derbyshire
Nottinghamshire
Leicestershire
Warwickshire
Worcestershire
Gloucestershire
Derbyshire Nottinghamshire Leicestershire Warwickshire Worcestershire Gloucestershire
AMEY order numer
Are courtesy boards set out?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is site specific risk assessment valid?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
If required by location do operatives have NRSWA accreditation ?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Do operatives carry EUSR safe digging cards?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Are visitors inducted by ganger / team leader?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Are ID cards carried by operatives?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Additional comments
GENERAL SAFETY CHECKS
PPE Worn?<br>Helmet,high viz, safety footwear, risk assessed other as required
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Utility drawings available ?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Services identified and marked?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
CAT and genny 4 on site and in use?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Operatives have Leptospirosis cards?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Suitable site access and egress where required
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Operatives aware of accident/ hazard reporting procedure?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
In date gang pack on site?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is the Health, Safety and Environment pack available and at correct issue status?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Additional comments
PLANT AND EQUIPMENT CHECKS
Plant stored safely away from excavation ?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Plant suitable for operation?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Plant in good condition
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Suitable straps available to secure excavator on trailer
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Operatives trained and competent to use plant on site ?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Dust suppression available?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Test, inspection, calibration certificates available?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
All plant within service / calibration date
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Additional comments
EXCAVATIONS
Excavation shored where required by depth / conditions?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Materials stored in safe location away from watercourse / drains
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Operatives trained in trench support?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
If temporary works are required is design available
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is inspection regime in place
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is suitable access / egress available
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Has check been carried out to ensure excavation does not undermine any structures?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is methodology and plant suitable for works being carried out?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Are siting services / ducts correctly supported?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is there adequate edge protection in place
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is spoil stored sufficient distance from excavation ?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
If heras fencing is required and used is it double clipped?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is deep excavation signage in place on site?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Additional comments
WELFARE AND HYGIENE
Are team / gang aware of public convenience location?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Are wash facilities / wipes available onsite
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Are there adequate drinking water facilities on site
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Additional comments
STREETWORKS
Are correct barriers / signs set up ?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is all plant / equipment inside barriers?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Sandbags used where necessary?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Are pedestrian walkways suitable and fit for purpose?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Are kerb ramps if used fit for purpose and secure?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
If used are footway boards fit for purpose?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
If traffic lights are used are they correctly set up ?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Are stop / go boards available if required ?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Are materials / spoil / stores correctly guarded?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is there an information board on site ?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Are vehicles parked considerately ?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is there a copy of the street works red book on site?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Additional comments
VEHICLE
Are vehicle and trailer tyres in roadworthy condition?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is the driver correctly trained / certificated to drive vehicle and or tow if required.
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is there a fitted and working flashing beacon on plant / vehicle
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Are vehicle defects recorded and has depot been advised of defects?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Are keys removed from vehicle when not in use and is vehicle secure when not in use?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Are all loads secure and covered where necessary
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is windscreen free from damage
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Does vehicle appear overloaded?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Additional comments
CONFINED SPACE ENTRY
Is there a charge, calibrated and in date gas detector on site?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Has atmosphere been tested prior to entry?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Are operatives trained for confined space entry?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is there sufficient light for the working area?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Are tools and equipment suitable for the working environment and maintained / tested / calibrated?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is there safe access and egress?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is there suitable ventilation?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Additional comments
CUSTOMER
Has customer impact been assessed?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Has customer been informed of the works?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Does site project the correct image?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Additional comments
EMERGENCY ARRANGEMENTS
Are there an adequate number of first aides on site?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is the fire extinguisher in the vehicle serviced yearly?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is there a suitable first aid box with eye wash on site?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Additional comments
ENVIRONMENTAL
Are chemicals and fuels stored in bunds and prevented from accidental damage?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is spoil stored to prevent risks to watercourses?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is a spill kit available on site?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is there adequate storage for hazardous substances?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is noise kept to a minimum?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is dust suppression carried out to reduce dispersion?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is care taken to prevent damage to tree roots ?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is waste segregated and stored correctly?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Additional comments
COMPANY IMAGE
Are all operatives wearing correct corporate or non badged PPE ?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is clothing in acceptable condition?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is clothing reasonably clean and visible?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is vehicle clean, tidy, displaying correct livery and free from damage?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Have any customer queries been resolved?
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Is there a physical barrier between cab and rear of vehicle
0. NOT CHECKED
1. CHECKED OK
2. RECTIFIED ON SITE
3. NOT RECTIFIED ON SITE
Additional comments
Inspected by:
Sign
link copied
Nigel Unknown
2016 01 18 MSN SITE AUDIT
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