Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Position of Conductor

  • Dept/Contractor

  • Location
  • Name of Person in Charge

  • Number in Team

  • Name of COSS / PC/ ES

  • Sentinel No

Immediate Observations

  • Detail of Work being undertaken

1. Health and Safety

  • Is there a Site Office?

  • Is the access of a good standard?

  • Was the Site Briefing carried out?

  • Is all Site Documentation/Task Documentation on site?

  • Has all Electricity on site been accounted for?

  • Is all Staff PPE Correct?

  • Is Welfare on site sufficient and cleaned?

  • Was the site clean and tidy, with all materials stored correctly?

  • Has the First Aid person/kit been identified?

  • Were all the necessary H&S Documentation displayed?

  • Are all Permits in place for the required work?

  • Are all Flammables stored correctly and clearly marked?

  • Is there a Fire extinguisher present, and all flammables far away from Hot Works?

  • Are all Hand Tools well maintained, inspected and used by a competent person?

  • Have all the necessary Security measures been adhered to?

  • Have all staff recieved Manual Handling training and all tasks risk assessed?

  • Have all COSHH items had the required assessment?

  • Are all materials Stored correctly and safely, clearly labelled?

  • 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.

  • Are all correct measures in place to ensure Public Safety?

  • Does the team have the required tools to Work at Height?

  • Are the necessary Traffic Management procedures in place?

  • Have the questions/concerns of the Work Force been listened to or answered?

  • Have all control measures regarding Noise been implemented?

  • Have all Hand Arm Vibrations (HAVs) related tasks been risk assessed correctly?

  • Does all Plant and Equipment have the required documentation, certification and SSOW?

  • Has all of the Lifting Equipment undergone the necessary inspections/examinations? Relevant plans?

  • With Breaking Ground/Excavations, have they been checked for Utility Plans, GPR/CAT Scanning, PTW, Safe Digging, Temporary Works, Calibration of CAT, Competency?

2. Item Inspections/ Observations

  • Have the team been briefed about the Safety Reporting Arrangements?

  • Has the Signaller been Notified?

  • Have the team been briefed about the Protection Arrangements?

  • Was the Supervision of Works sufficient?

  • Was the Safe System of Work sufficient?

  • Were all of the Sentinel Checks completed?

  • Any other concerns regarding Item Inspections/Observations?

3. Planning and Documentation

  • Have Colleagues been briefed on environmental aspects and the associated risks and opportunities on site?

  • Are Operational Control Procedures available and briefed to manage these Risks and Opportunities?

  • Have all Licenses/Permits/Consents (ecology, noise, discharge, waste) been received for the relevant site works: Are conditions being met?

  • Have Environmental actions been implemented from previous HSEQ Inspections?

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

4. Nuisance: Noise, Vibration, Visual

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

  • Are Section 61 noise consents in place, all plant/equipment listed, conditions followed?

  • Are Barriers and other mitigation measures (BPM) being used to limit noise and vibration?

  • 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

  • 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?

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

5. Ecology

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

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

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

  • Have you ensured vegetation clearance is not done during nesting season (Mar-Aug), or pre-start checks are conducted by competent person(s)?

  • Is there a procedure set for reporting unexpected finds (nesting birds/badger setts/newts); are site workers aware of the procedure? Coruson Close Called?

6. Air Quality

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

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

  • Are there signs of fumes from equipment/vehicles? (Excluding exhaust fumes)

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

7. Oil storage, fuel and bunding

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

  • Are bunds at 110% capacity of the greatest or 25% of total tank volume, and structurally sound?

  • Are drip trays/others available for plant when refuelling?

  • Are oils stored away from storm drains, ditches, watercourses, sensitive areas and no visible contamination around the storage area?

8. Emergency Response

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

  • Have you ensured there is no visible pollution in storms drains, ditches (dry/wet), watercourse?

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

9. Waste

  • Has a SWMP been implemented and briefed on site? Is it being adhered to?

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

  • Is waste segregated, labelled and secured?

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

  • Are waste containers/skips clear, not overfilled, and no loose trash/litter around?

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

10. Energy, Resources and Timber

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

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

  • Is the Site utilising low carbon fuels where possible?

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

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

11. General Competency

  • Has the Quarantine Area been clearly Identified or process briefed out?

  • Has the work been carried out to the required standard, has all work been carried out in line with the methodology stated on site?

  • Have all of the required test and inspections relating to the works been carried out, completed and documented?

  • Have all of the relevant calibration regarding works been completed and documented?

  • Are all Certificates of Conformity accessible?

  • 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)?

  • Have all Temporary Works been designed by a competent Temporary Works Professional, and is all the relevant documentation available?

  • Any additional information/issues/problems or points regarding the quality of the work being carried out?

Summary of Findings

  • Overall Comments

  • Authority to Work - Competence Criteria Observed (add observed Employee Name and Criteria)

  • Future Actions

  • Detail of Actions to be Taken

  • Actions to be Taken by Who

  • Date of Actions to be Taken

  • Please Sign Name

  • Please Print Name

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.