Title Page
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Site conducted
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Client / Site
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Conducted on
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Prepared by
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Location
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INSTRUCTIONS
1. Please answer "Yes", "No" or "N/A" on the questions below.
2. Add Photos and Comment by clicking on the paperclip icon
3. To add a Corrective Action click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority, and due date
4. Complete audit by providing digital signature
5. Share your report by exporting as PDF, Word, Excel or Web Link
Technicians
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1 Appearance to high standard.
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2 Work standard to high standard.
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3 Correct PPE issued and inspected.
PPM
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4 Schedule up to Date.
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5 Plant Labels if Used.
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6 Sample PPM Tasks Checked and satisfactory.
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7 Contractor Authorisation to Work / Induction completed and satisfactory.
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8 Sample Contractor PPM Tasks Checked.
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9 Contractor appearance satisfactory.
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10 Contractor conduct satisfactory.
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11 Contractor punctuality satisfactory.
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12 Contractor work standard satisfactory.
Call-out
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13 Call out rota in place and valid.
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14 Call out rota known by Client/Security/Office.
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15 All areas clear, good standards observed.
Tools
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16 Technicians tools in safe condition.
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17 Tools lists up to date.
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18 Guarding in place.
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19 Emergency Stops operational.
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20 New calibration certificates sent to Regional Office.
Safety
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21 Incidents reviewed & results sent to H & S Manager.
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22 Risk Assessments/Method Statements up to date.
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23 New Hazards to assess.
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24 Permits in use where applicable.
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25 Work Areas (Access & Egress).
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26 Compressed Gas Cylinders stored according to in country legislation.
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27 Warning Notices / Emergency Procedures defined.
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28 Temperature, Ventilation & Lighting.
Training
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29 Training records up to date.
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30 Tool Box talks held.
Electrical
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31 Are Records of changes to installations carried out by a registered electrician.
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32 Where required, is the site Fixed Electrical Installation Certificate available.
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33 Are electricians competence records available.
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34 Are Lightning Protection Inspection records available for site.
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35 Are electricians competence records available.
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36 Are HV Equipment Operation records available for the site.
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37 Are Appointment Certificates in place for HV AC authorised Competent Engineers.
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38 Emergency Lighting Tested and Certificate available.
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39 Are LOTO Kits and Proving Equipment available.
Water Hygiene
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40 Where required, have Water Hygiene Risk Assessments been carried out.
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41 Are Cooling Towers notified to authorities where required by legislation.
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42 Are Dipslide / Bioscan results available for site?
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43 Are Clean / Chlorination Records (Cooling Towers) available for site.
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44 Are Legionella Test Records (Cooling Towers) available for site.
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45 Are TVC Test Records (Cooling Towers) available for site.
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46 Are Clean / Chlorinated Records (Domestic System) available for site.
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47 Are Legionella Test Records (Domestic System) available for site.
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48 Are TVC Test Records (Domestic Systems) available for site.
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49 Tap Temperatures taken and recorded, action taken if out of range.
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50 Are the calibration certificates on file.
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51 Flushing of little used outlets.
Fire
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52 Are Emergency Lighting Test Records available for site. √
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53 Are Fire / Smoke Detection, Alarm System Inspection / Maintenance records available for site.
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54 Are Sprinkler System Inspection / Maintenance records available for site.
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55 Are records of Sprinkler Main Pump Tests available for site.
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56 Are Fire Suppression System (Ansul / Mist / Gas) Test Records available for site.
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57 Are Room Integrity Test Records available for site.
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58 Are High Pressure Cylinder Inspection Records available for site.
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59 Are Fire Extinguisher / Fire Blanket Inspection / Maintenance records available for site.
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60 Are Hose Reel Inspection / Maintenance records available for site.
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61 Are Wet / Dry Riser Inspection / Maintenance records available for site.
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62 Are Fire Door Inspection / Maintenance records available for site.
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63 Are records of Stairwell Pressurisation System Checks available for site.
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64 Is a Fire Risk Assessment available for site and have all actions been addressed.
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65 If breaches in fire stopping have been identified has corrective action been taken.
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66 Fire Exits Clear, Evacuation Procedure in place.
Asbestos
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67 Has an Asbestos Survey been carried out where ACM's may be present on site.
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68 Is there an Asbestos Management Plan in place.
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69 Are Re-Inspections against the Asbestos Register carried out as per the Asbestos Management Plan.
F-Gas
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70 Is there an FGas Register in place.
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71 Are Refrigeration System Maintenance Records in place.
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72 Are Leak Test Records in place for FGas Systems.
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73 Is Refrigerant Usage for FGas Systems recorded.
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74 Has an Initial Environmental Review for the site been been undertaken.
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75 Have Operational Control Procedures been documented for significant aspects.
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76 Is there a Pollution Prevention Response Plan in place.
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77 Are Environmental Permits in place (Discharge Consent, Abstraction Licence, Fuel Storage, etc).
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78 Have relevant Waste Producers Notifications been obtained.
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79 Are Vendors' Waste Carriers Licences available.
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80 Is an Annual Transfer Note / Season Ticket in place for general waste streams / recycling.
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81 Copies of all Consignment Notes & Controlled Waste Transfer Notes on file (covering a minimum of 3 years).
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82 Descriptions of waste correct.
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83 Waste adequately stored.
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84 Waste removed appropriately.
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85 Staff instructed to carry company Registered Waste Carrier certificate if transporting waste.
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86 Staff aware of procedures for safe removal of waste.
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87 Staff aware of emergency procedures relating to waste removal.
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88 Is site registered as producer of hazardous waste (office blocks & shops are exempt if hazardous waste weighs less than 500kg/year).
Lifting Equipment
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89 Inspection & Examination of Lifts & Escalators records available.
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90 Insection & Examination of Lifting Equipment records available.
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91 Insection & Examination of Lifting Accessories records available.
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92 Maintenance, Inspection & Examination of MEWPs records available.
Other Services
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93 Are Written Schemes of Examination for Pressure Systems in place and valid if applicable following in country legislation.
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94 Have Insurance Inspections been carried out for Pressure Systems as per the Written Scheme or in country equivalent.
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95 Are Maintenance records in place for Combustion Systems / Boilers.
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96 Has the maintenance of Combustion Systems / Boilers been carried out by Competent Persons.
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97 Are Maintenance records in place for Latchway Systems.
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98 Are Maintenance records in place for Runway Systems / Cradles.
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99 Are Maintenance records in place for Eyebolts.
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100 Are Maintenance records in place for Local Exhaust Ventilation (LEV).
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101 Has a Noise Survey / Noise Risk Assessment been carried out where noise levels may exceed 85db(A).
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102 Are Indoor Air Quality Testing Records available where required by Risk Assessment / in country legislation.
Spill control
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103 Are bunds in place.
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104 Are Spill Kits available.
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105 Is PPE available.
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106 Are washing facilities available.
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107 Are Site Drainage Plans available.
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108 Are Drains identified to show foul & surface water.
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109 Are Pollution Prevention Procedures in place.
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110 Are emergency contact details available.
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111 Are Hazardous Substances Assessments available.
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112 Are Consignment Notes / Controlled Waste Transfer Notes available.
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113 Are incidents recorded / reported.
Hazardous Substances
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114 Inventory list of hazardous substances complied for site.
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115 Material Safety Data Sheets available for each item on the inventory list.
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116 Hazardous Substances Assessments available for each item on the inventory list.
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117 Hazardous Substances Assessment available at the storage location and/or points of use.
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118 Is appropriate PPE available.
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119 Are employees exposed to hazardous substances monitored where applicable.
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120 Is Health Surveillance of employees monitored and recorded where applicable.
Clean Air
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121 Is contract in an Air Quality Management Area or Smoke Control Area (check with Local Authority)? If yes, no smoke to be emitted.
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122 Are new boilers notified to local authority or other government body following in country legislation.
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123 Are there any Local Authority emission limits in place? If yes, are limits adhered to. (where issue arises e.g. boilers advised the client).
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124 Are boilers regularly serviced.
Ozone Depleting Substances
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125 Is all equipment containing ozone depleting substances properly serviced to prevent leaks.
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126 Are all ozone depleting substances recovered and recycled?
Tap Water
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127 Is an Operational Control in place.
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128 Has a water-sampling regime been established where necessary.
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129 Are the water sampling records in place.
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130 Are the calibration certificates on file?
Local/Third Party/Other Requirements
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131 Are Local/third party/other requirements being adhered to.
Operational Controls
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132 Are Operational Controls documented where applicable.
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133 Are Operational Controls communicated to staff.
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134 Are Operational Controls used & effective.
Hazards
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135 Hazard reporting records available and actions closed out.
Completion
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General Comments/Observations:
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Customer Comments:
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Manager: (Name and Signature)
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Customer: (Name and Signature)
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On a scale of 1-10 (10 most likely), How likely would you be to recommend our services? Please select relevant number
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