Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location
  • Position

  • Dept/Contractor

  • Name of Person in Charge

  • Number in team

  • Name of COSS / PC / ES (as applicable)

  • Sentinel No.

  • Detail of Work being undertaken

Health & Safety

  • 1. Is there a Site Office?<br>-If applicable, state where the site office is located and if the signage is clearly displayed to the office and at the office.<br>

  • 2. Is the access of a good standard? <br>-Is the Site Access secure with a padlock? Is it clear of materials and well maintained?<br>

  • 3. Site Briefings<br>- Was the briefing carried out, was the information in the briefing sufficient for the task being carried out. Were the Hazards & Control measures associated with the task communicated?<br>

  • 4. Is all Site Documentation/Task Documentation on site?<br>- Was all the correct site documentation present such as H&S Policy statement, Insurances, Environmental Policy statement. Did the Teams have the correct Safe Work Pack or Method statement for the task and supporting documentation such as permits, ALO plans etc.

  • 5. Has all Electricity on site been accounted for?<br>- Was all the electricity clearly identified for the task, was a form C needed to carry out the work and if so, was it present. Was Test before Touch method used correctly<br>

  • 6. Is all Staff PPE Correct?<br>- Did all staff/contractors have the required PPE as identified in their Risk Assessment to carry out the task, Was the PPE in good condition with the sponsor displayed?<br>

  • 7. Is Welfare on site sufficient and Cleaned? <br>~ Does the Welfare meet the requirement of the staff number on site, set out by Schedule 2 CDM regulations i.e. was there washing facilities available, adequate drinking water available, was the condition of the facilities clean, tidy and well maintained<br>

  • 8. House Keeping<br>~ Was the site is clean and tidy, was all materials stored correct, was all tools stored correctly, are all walking routes clear from tripping hazards<br>

  • 9. First Aid<br>- has the First aid person clearly Identified and qualified to the required standard set out in the First Aid Procedure. Was there sufficient First Aid Supplies on site and was the First Aid Box/Bag checked before work commenced.<br>

  • 10. Notice Boards<br>- Was all the necessary H&S documentation displayed i.e. the H&S Law Poster

  • 11. Permits <br>- Are all permits in place for the required work i.e. Permit to Dig, Working at Heights Permit etc..

  • 12. Flammables<br>-Are all flammables stored in the correct containers and clearly marked

  • 13. Fire<br>- Have all control measure been put in place to ensure that all flammable items are away from Hot Works. Is there a Fire Extinguisher present at all Hot Works and Re-fuelling areas?

  • 14. Hand Tools<br>-Are all hand tools well maintained, inspected if needed and being used by a competent person?

  • 15. Security<br>-Have all access points been secured after entering the Infrastructure or work site. Does the Work site have a complete perimeter fence in good Order? Are all OTP Stored correctly and not left in Machines?

  • 16. Manual Handling<br>- Have all staff received Manual handling training, has the task been risk assessed correct to rule out mechanical assistance etc

  • 17. COSHH<br>- Has all COSHH items had the required COSHH assessment and is the assessment easily accessible?

  • 18. Storage of Materials<br>-Are all materials stored safely and correctly in the correct areas? Are materials Labelled, Segregated, Covered and stored in a secure area. <br>-Are all containers clearly labelled with Corresponding substances carried<br>- Are materials stored away from storm drains, ditches, watercourses, environmentally sensitive areas?<br>**Good practice states that polluting substances should be stored more than 10 metres from the nearest receptor, i.e. watercourses or drains. The first step is to know where receptors are.

  • 19. Public Safety<br>- Have all the necessary control measure been put in place to ensure that no member of public can interact with works?

  • 20. Work at Height<br>-Does the team have the required Permit to work at heights, have all staff/contractors have the required harness and its it inspected and serviceable

  • 21. Traffic Management<br>- Have all the necessary traffic management been set up correctly and in place before work commences

  • 22. Consultation with Employees - Have any of the work force have H&S Safety concerns or Issues

  • 23. Noise<br>- Have all control measure identified by the Risk Assessment been implemented and sufficient for the task, are all Ear defenders of personnel carrying out the task serviceable

  • 24. Hand Arm Vibrations (HAVs/WBVs)<br>- Have all HAV related tasks been risked assessed correctly and operators been informed of the trigger time allowed for the equipment being used, have all trigger times been documented for each person<br>

  • 25. Plant & Equipment<br>- Does all plant and Equipment have the required documentation, certification, SSOW. Have all operators completed the necessary pre-work checks, have all operators signed onto the plant? Are the operators competent in the plant operations

  • 26. Lifting Equipment<br>-Have all lifting Equipment have the necessary inspections/examinations and in date. Does the Lifting equipment have the relevant lift plan? Does the lifting equipment have the necessary rescue plan if needed<br>

  • 27. Safety Reporting Arrangements<br>-Have the team been given clear guidance and reporting mechanisms for Safety/Technical issues

  • 28. Has the Signaller Notified <br>-Was the Signaller or ES notified and gave authority to access the infrastructure?<br>

  • 29. Protection Arrangements<br>~Was the correct safe guarded measures put in place for the work to be carried out? <br>

  • 30. Supervision of Works<br>- Was the correct level of supervision for the task being carried out sufficient, was there clear control of the works being carried out

  • 31. Sentinel Checks<br>- Was all Sentinel card scanned into the Sentinel system to ensure the correct competencies and record access to the railway infrastructure

Environmental - Planning and Documentation

  • 32. Have Colleagues been briefed on environmental aspects and the associated risks and opportunities on site?<br>- Consider how they are briefed and how frequently. E.g inclusion in task briefing, toolbox talks, including incident response

  • 33. Are Operational Control Procedures available and briefed to manage these Risks and Opportunities? <br>-These should be consistent with what has been included in any EMPs

  • 34. Have all Licenses/Permits/Consents (ecology, noise, discharge, waste) been received for the relevant site works: Are conditions being met?<br>- E.g. Section 61, EPS mitigation licenses, discharge consents, waste permits/exemptions

  • 35. Have Environmental actions been implemented from previous HSEQ Inspections?

  • 36. Are Emergency Plans in place; Are Site Workers aware of incident response procedures?

Environmental - Noise, Vibration, Visual

  • 37. Are local authority/local residents informed of the works?

  • 38. Section 61 noise consent in place, all plant/equipment listed, conditions followed (e.g. barriers, work hrs.)?

  • 39. Are Barriers, and other mitigation measures (BPM) being used to limit noise and vibration?<br>-Best Practicable Means: BPM are defined in Section 72 of the Control of Pollution Act 1974 and Section 79 of the Environmental Protection Act 1990 as those measures which are: “reasonably practicable having regard among other things to local conditions and circumstances, to the current state of technical knowledge and to financial implications”

  • 40. Is plant in good order, away from site boundaries and turned off when not in use? In addition, are vehicles waiting to enter the site turned off?

  • 41. Has site neighbour’s view of site been considered: Confirm there is no light spilling over, portable screens are being used, etc.?

Environmental - Ecology (protected species/areas and invasive species)

  • 42. Are protected species/areas known, measures (e.g. fencing) used to minimise impact?

  • 43. Have invasive species been identified and means implemented to prevent spreading?

  • 44. Are Tree Preservation Order (TPO) Zones Signed and fenced off?

  • 45. Ensure vegetation clearance is not done during nesting season (Mar-Aug) or pre-start checks conducted by competent person(s)

  • 46. Is there a procedure set for reporting unexpected finds (nesting birds/badger setts/newts); are site workers aware of the procedure?<br>-Use of Coruson Close Call reporting system to report unexpected finds associated with ecology risks.

Environmental - Air Quality (Fumes) and dust

  • 47. Is hard standing and road free of mud/dust. Unsurfaced damped down?

  • 48. Are vehicle loads kept covered and wheels clean when entering and leaving site? Are vehicles wheels washed on exit and entry to site

  • 49. Are there signs of fumes from equipment/vehicles?<br>-Excluding exhaust fumes

  • 50. Is particulate monitoring being undertaken on site in dust heavy zones

Environmental - Oil Storage, fuel and bunding

  • 51. Are tanks, barrels, drums, securely stored, in good state and in a bunded area?

  • 52. Are bunds 110% capacity of the greatest or 25% of total tank volume, if there is a cluster (whichever is greatest)? and structurally sound; i.e. no cracks, holes or leaks? – In Wales this only applies to oil Storage >200L

  • 53. Are drip trays/others available for plant when refuelling

Environmental - Emergency Response

  • 54. Are spill kits available near potential spill areas: suitable/adequate for type/ amount of fluid used/stored

  • 55. Ensure there is no visible pollution in storms drains, ditches (dry/wet), watercourse?

  • 56. Have protective measures, where required, been implemented for drains, ditches and water courses

Environmental - Waste Management

  • 57. Has a SWMP been implemented and briefed on site? Is it being adhered to?<br>-Site Waste Management Plan

  • 58. Is spoil handled properly (away from watercourses/covered?

  • 59. Is waste segregated, labelled and secured?

  • 60. Are waste transfer notes and hazardous waste consignment notes held on site and have they been completed correctly?

  • 61. Are waste containers/skips clear, not overfilled, no loose trash/litter?

  • 62. Has the works team demonstrated the effective reuse of materials/waste, either on the project site or offsite on another project?

Environmental - Energy, Resources and Timber

  • 63. Is energy efficient machinery, plant and equipment being used and maintained?

  • 64. Has the use of renewable energy been considered e.g. Solar panels, hybrid generators?

  • 65. Is the Site utilising low carbon fuels where possible?

  • 66. Is water use being minimised on site? Are water reuse initiatives being implemented on site?

  • 67. Is evidence available to demonstrate that the timber being used is credibly certified to FSC/PEFC standard?

Quality

  • 68. Quarantine Area<br>-Has the Quarantine Area been clearly Identified or process briefed out?

  • 69. Workmanship Standard<br>-Has the work been carried out to the required standard, has all work been carried out in line with the methodology stated on site?

  • 70. Inspection & Test records<br>-Has all the required test and inspections relating to the works been carried out, completed and documented?<br>

  • 71. Calibration<br>-Have all relevant calibration regarding works been completed and documented?

  • 72. Certificates of Conformity

  • 73. Competence<br>-Do all Employees/Contractors hold the necessary competency to carry out the duties of the task they’re completing. ATW/Safety Critical Competencies/CSCS Cards

  • 74. Temporary Works<br>-Have all Temporary Works been designed by a competent Temporary Works Professional, is all the relevant documentation available?<br>

  • 75. Other<br>-Any additional information/issues/problems or points regarding the quality of the work being carried out? <br>

Additional Notes / Comments

  • Additional information and comments

  • Overall summary of findings

  • Authority to Work - Competence criteria observed (add observed employee name and criteria)

  • Details of action to be taken (by who, date)

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