CC (CF)Health & Safety Site Assurance Audit

• CONTRACT

• SITE AGENT

  Select

• AUDITOR

  Select

• GANG ID

  Select

• GANG LEADER

• DIRECT OR SUBCONTRACTORS

  Select

• DATE AND TIME

  Date

• PN NUMBER (eg..PN46, PN1438

• Location
  Address

Auditors RISK ASSESSMENT / SAFETY CHECK

• Safety Check - If you answer 'No' to any of the appropriate action

  Yes

  No

  N/A

• Safety Check - If you answer 'No' to any of the following 3 questions, end the audit and take appropriate action. answer, take the appropriate action and, when safe to do so, continue the audit

• Is it safe for you to conduct this audit?

  Yes

  No

  N/A

• Is it safe for the construction workers to continue work?

  Yes

  No

  N/A

• Is it safe for members of the public, in the areas surrounding the site, that they are able to access?

  Yes

  No

  N/A

Signing Lighting & Guarding

• Are CityFibre approved Permit/Courtesy Boards displayed and contain PHOTOS

  Yes

  No

  N/A

• Are Advanced warnings signs in correct sequence, distance and suitably fixed to prevent being blown down or out of position? PHOTOS

  Yes

  No

  N/A

• Are all signs, cones, barriers (SLG) in good condition (no damage)? PHOTOS

  Yes

  No

  N/A

• Is the lighting adequate for the works being carried out?

  Yes

  No

  N/A

Barriers and Work Area

• Are Traffic / Pedestrian Segregation Barriers fitted?

  Yes

  No

  N/A

• Are all barriers set up correctly as per the Code of Practice (Red Book.)including all gate entrances?

  Yes

  No

  N/A

• Are barriers supported by suitable bases?

  Yes

  No

  N/A

• Is all the working equipment contained within the barriered work area?

  Yes

  No

  N/A

• Are all barriers linked together with no gaps and suitably fixed to prevent blowing down or out of position?( Including all gate entrances )

  Yes

  No

  N/A

• Is the site closed (barriered / guarded) on all sides?

  Yes

  No

  N/A

• Is work area of a suitable size to operate safely?

  Yes

  No

  N/A

Footways.

• Are alternative pedestrian arrangements required?( ie Pedestrian re-routing, narrowing of walkway,road crossing)

  Yes

  No

  N/A

• Are doorway Covers/Ramps fitted, fixed and a correct loading for the task?( vehicle or pedestrian)

  Yes

  No

  N/A

• Are alternative pedestrian arrangements in place and adequate (i.e. Pedestrian re- routing, narrowing of walkway, road crossing)

  Yes

  No

  N/A

• Are footway Covers/ Ramps fitted, fixed and a correct loading for the task?(ie vehicle or pedestrian)

  Yes

  No

  N/A

• Are footway closed signs in use?

  Yes

  No

  N/A

• Are pedestrian diversion signs in place and correctly fitted? (Is it immediately obvious what is happening and what is expected of me/pedestrians and traffic)

  Yes

  No

  N/A

• Is the pedestrian walkway the correct width? (at least 1.2MTRS)

  Yes

  No

  N/A

• Is there a safe method for pedestrians to avoid the road / carriageway whilst passing works?

  Yes

  No

  N/A

• Footways - SITE COMMENTS

Environmental

• Is spoil stored and contained in appropriate, barriered off, area(s)?

  Yes

  No

  N/A

• (Environmental considerations i.e. away from water courses, tree canopies & drainage, not covering a fire hydrant.)

  Yes

  No

  N/A

• Have all excavation works taken place as advised by the NJUG tree protection zone? SROH - NG1.10.1

  Yes

  No

  N/A

• - Prohibited (no excavation) - within 1m of the tree trunk

• - Precautionary (no mechanical excavation) - within 4x the circumference of the tree trunk?

• Is there a site appropriate spill kit available for any environmental issues, fuel leaks etc

  Yes

  No

  N/A

• Are contaminated materials stored on appropriate protection? (Select NA if there are no contaminated materials on site)

  Yes

  No

  N/A

Traffic Management

• IS TRAFFIC MANAGEMENT SUITABLE AND COMPLIANT WITH CHAPTER 8

  Yes

  No

  N/A

• Traffic management- SITE COMMENTS

House Keeping

• DOES THE SITE SHOW EVIDENCE OF GOOD HOUSEKEEPING ; TIDY ,ORGANISED ,STORED EQUIPMENT....ETC

  Yes

  No

  N/A

Plant & Equipment

• AS A DAILY /WEEKLY PLANT EQUIPMENT CHECK SHEET BEEN COMPLETED

  Yes

  No

  N/A

• BREAK CABLE , RATCHET STRAPS IN GOOD CONDTION ?

  Yes

  No

  N/A

• IF POOR CONDITION IDENTIFIED ITEM MUST BE REMOVED FROM SITE IMMEDIATELY

• Are plant /equipment etc in good operational order, with beacons where required ?

  Yes

  No

  N/A

Cat, Genny and GDU

• Are CAT & Genny working and in Calibration date

  Yes

  No

  N/A

• IS GAS DETECTOR WORKING AND IN CALIBRATION

  Yes

  No

  N/A

• Site Comments (Plant & equipment)

Documentation

• Has site risk assessment been conducted and suitable for the current operations?

  Yes

  No

  N/A

• Have all operatives signed the Risk Assessment or evidence of briefing?

  Yes

  No

  N/A

• Are method statements in use and applicable?

  Yes

  No

  N/A

• Are COSHH Assessment and Safety Data Sheets available for all hazardous substances held on site?

  Yes

  No

  N/A

• Are utility drawings onsite, available, legible and in date? (ordinarily 28 days from date of issue)

  Yes

  No

  N/A

• Are gang following HSG47 guidelines , provide evidence;spray markings, trial holes ,banksman watching machine dig ....

  Yes

  No

  N/A

Noticing and Competence6

• Are NRSWA Noticing / TTRO's in place and displayed?

  Yes

  No

  N/A

• Have Streetworks personnel got the relevant NRSWA Cards and plant certificates in date, appropriate and available for inspection? (Original / Print / Digital)

  Yes

  No

  N/A

• List Names of operatives sampled

• Site Comments (Noticing)

Fire -

• Are Fire Extinguishers held in vehicle or on site?

  Yes

  No

  N/A

• Is there an expiry date on the fire extinguisher? (Annual service record)

  Yes

  No

  N/A

• What is the expiry date of fire extinguisher?

Welfare -

• Welfare - For guidance see CDM Code of Practice Schedule 2

• Are drinking water and vessels made available to the operatives?

  Yes

  No

  N/A

• Are washing facilities available (including warm water, sink, soap & hand towels)?

  Yes

  No

  N/A

• Are toilet facilities within a ten minutes walking distance?

  Yes

  No

  N/A

• Are site First Aiders Qualified?

  Yes

  No

  N/A

• Is First Aid Kit stocked suitably for the work being carried out and content in date? For guidance see INDG214, Q4

  Yes

  No

  N/A

• Expiry date of stocks

  Yes

  No

  N/A

• Site Comment (Welfare)

PPE -

• IS PPE BEING USED , READILY AVAILABLE

  Yes

  No

  N/A

• Check for ; dust masks, gloves, safety glasses, hard hats and ear defenders

• Is the CityFibre logo on the contractors PPE? (NA- if flame retardant PPE is required) provided?

  Yes

  No

  N/A

• Site comment (PPE)

COMPLETION -

• WERE ALL FAILS CORRECTED AT TIME OF AUDIT ?

  Yes

  No

  N/A

• (They do not have to agree the findings but must acknowledge your audit)

• Discuss your findings with the team. Encourage them to give you feedback. Help identify where we can improve safety, quality and welfare. Encourage reporting and explain why it is so important to Callan Connects future. If you agree to raise an issue on their behalf make sure you keep you promise!

• FOREMANS Signature of recognition of findings

  Sign

• GANG FEEDBACK.....

Sign Off

Sign Off

• Auditor Signature

  Sign

• Would you like to highlight any good practice?

  Yes

  No

  N/A