Title Page
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Conducted on
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Prepared by
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Area/department
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Document number
Health, Safety & Environmental Inspection/ Behavioural Observations
Section 1: General Health & Safety
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1.0) Are the walkways clear?
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1.1) Have the Engineers & Contractors in the area wearing red jackets and got a permit to work?
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1.2) All Mandatory signage present & in good condition in the area?
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1.3) Is GMP being observed in area?
Section 2: Machinery
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2.0) Are pre start checks completed on the machinery being observed?
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2.1) Check 2 Machine safety switches/ interlocks (working / undamaged)
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2.2)Are bolts missing from the guards of (check 2 machines)
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2.3) Are guards in good condition on (check 2 machines)
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2.4) Check operation of 2 E- Stops
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2.5) Does the machinery display safety signs? (i.e. Cut risk)
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2.6) Is the pre start check completed reflective of the state of the machine?
Section 3: Electrical
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3.0) Are there holes in any panels? (check 2 machines)
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3.1) Are any of the padlocks missing off any panels? (check 2 machines)
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3.2) Are any wires/ cable exposed?
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3.3) Are Isolators intact on any machines/ panels?
Section 4: COSHH
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4.1) Are chemicals clearly labelled? (are point of use chemical displaying a sign)
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4.2) Are the chemicals chained up?
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4.3) Is there evidence of any chemical leakage/ spillage?
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4.4) Are operatives wearing the prescribed PPE?
Section 5: Emergency Aids
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5.0) Are any spill kits tags still in place?
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5.1) Is the fire equipment blocked? i.e. fire extinguishers, call points
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5.2) Are the emergency escape routes clear?
Section 6: Behavioral Observations
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6.0) have you observed any horse play?
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6.1) Are Employees/ agency/ contractors putting themselves and others at risk?
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6.2) Have you engaged in a conversation with an operative?
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6.3) Brief summary of discussion
Section 7: PPE
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7.0) Is hearing protection being worn in mandatory hearing protection areas?
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7.1) Are protective gloves being worn in line with the SOP/ SSOW and risk assessment?
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7.2) Is protective footwear being worn in Mandatory foot protection areas?
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7.3) Have the wellies in the changing room areas got sufficient tread?
Section 8: Work at Height
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8.0) Are mobile steps tagged?
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8.1) Are mobile steps being used on even ground?
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8.2) Do any of the gantries have defective steps?
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8.3) Do any of the gantries have defective handrails or missing handrails?
Section 9: Environmental
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9.0) Is waste being segregated? (i.e. Food, cardboard, plastic, paper and general)
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9.1) Is machinery running whilst not in use?
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9.2) Is the lighting sufficient?
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Signature:
