Information

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Excavations

  • Is safe digging practices being observed

  • Are exposed services suitably supported/protected

  • Is protection provided to prevent falls into excavation

  • Excavations suitably supported and safe access/ egress provided

  • Other comments

Vehicle/welfare

  • Is the vehicle clean and tidy. <br><br>

  • Are wash facilities suitable

  • Is there any sign of damage/ Faults

  • Are toilets in good order and well stock

  • Are first aid provision available and suitable for task

  • Fire extinguishers available and in good order

  • Other comments

Administration/Documentation

  • Are risk assessments produced for task.

  • Is a task method statement developed and briefed

  • Is a permit to work in place and authorised

  • Is there a lift plan in place is it suitable for task

  • Are service/utilities drawings available and current issue

  • Do operatives hold appropriate competency/training cards and up to date

  • Other comments

Personal Protective Clothing

  • Are operatives wearing appropriate PPE /RPE and is it in good order

  • Is disinfection equipment available

Plant and Equipment

  • Are electrical tools appropriate for task and in good order with P.A.T. Identified

  • Lifting equipment in good order and with in date examination certificate

  • CAT & Genny in good order and with in date calibration

  • Is plant and equipment in good order

  • Service/Mains fittings being stored in appropriate manner and in clean condition

  • Other comments

General site/ work activities

  • Are COSHH materials being used/stored appropriately and COSHH assessments available and in date

  • Protection to and from public- are measures implemented to ensure adequate protection.

  • Work at height - is work at height being conducted in safe manner with appraise controls in place.

  • Traffic management - barriers/ signage in good order and appropriate to task in accordance with chapter 8 NRSWA

  • Other comments

Environment

  • Housekeeping - site in good order with waste disposed correctly . Slip/trip hazards identified and controlled.

  • Is spill kit/ equipment available and in good order

  • Is the site free from spills/ leaks

  • Are sensitive areas nearby identified and suitable protection provided

  • Is there suitable lighting provided for task.

  • Other comments

Additional Comments

  • Any additional issues or good practices identified

Signatures

  • Site operatives/manager/supervisor

  • Auditor/inspected by

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.