Title Page
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Site conducted
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Company Name:
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Contractor Representative (Name & Position):
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Nature of work:
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Location:
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Major deficiencies (Immediate action required) 1 = Improvement Required, 2 = Satisfactory, 3 = Good
Monitoring and Control
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1. Relevant permits in place?
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2. Other relevant documentation / authorisation in place?
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3. Risk assessment / method statement specific to the work in place?
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4. Controls identified by the risk assessment in place?
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5. Method statement being followed?
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6. Site visitors log being used?
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7. Lone worker system in place and being used?
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8. Contractors aware of the site / their own emergency arrangements?
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9. Point of use risk assessments? (Identifying and controlling major hazards)
Training and Competence
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10. Evidence of contractor induction?
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11. Contractors have the required competencies for the task?
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12. Relevant training certificates available?
Working Area / Housekeeping
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13. Staff access and egress to the work area?
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14. Work area suitably barriered off and the other protected?
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15. Adequate signage?
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16. Work area generally tidy / materials and substances stored properly?
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17. Potential tripping hazards removed?
Hygiene and Welfare
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18. Suitable first aid arrangements in place?
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19. Suitable washing & toilet facilities available?
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20. Procedures for dealing with contact with sewage?
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21. Availability of sharps containers?
Safety and Personal Protective Equipment (PPE)
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22. PPE appropriate for the task being worn and consistent with RAMS?
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23. Fit for purpose - clean, well maintained, etc?
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24. Required safety equipment in use suitable and in good condition?
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25. Evidence of relevant calibration / test available?
Plant, Equipment, Materials and Environment
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26. Correct tools being used for the task?
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27. Tools maintained and fir for purpose?
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28. Relevant test / inspection records available? (i.e PAT Testing)
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29. Dangerous moving parts adequately guarded?
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30. Hazardous substances stored and labelled appropriately?
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31. Suitable chemical assessments and data sheets available?
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32. Suitable arrangements in place to prevent pollution?
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33. Arrangements in place to protect themselves and other against noice, dust, vibration etc. ?
Other
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(The following section can be tailored to suit the contractor / type of work. If not used ensure NA is entered in the score section.)
Sign-Off
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Inspection competed by:
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Date & Time:
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Sign:
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Distribution: