Information
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Document No.
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Audit Title
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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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Personnel
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Add media
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Select date
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Add location
Vehicle Check
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Vehicle Tax In Date
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Working + Clean Roof Mounted Beacons
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Chevrons On Rear Of Vehicle Inclusive Of Frame
Health & Safety Risk Assessment + Method Statement
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Near Miss Book
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COSHH Sheets
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Method Statement & Risk Assessment Signed?
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Generic Risk Assessment & Method Statement held on van
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Site specific Risk Assessment & Method Statement on Van?
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Site File containing Training Certificates and Local Emergency Locations?
PPE
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Hard Hat
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Hi Visibility Clothing Must Be Long Sleeved
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Hi Vis Trousers for Night Works
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Ear Defenders
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Eye Protection
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Suitable Gloves for Relevant Works
Signing Lighting & Guarding - Chapter 8
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2 Men at works signs
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2 Arrow signs
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2 road narrow signs
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12 Cones (750mm)
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Chapter 8 Book (small red book)
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2m Lengths of cable matting
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2 x Ramp Signs
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Barrier System with BB number clearly visible?
Ancillary Equipment
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Standard Man Hole Keys
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Small Manhole Keys (S24)
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5 Foot Wrecking Bar
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Crow Bar
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Pinch Bar
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Over shoes
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Spill kit?
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Dust Sheets
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Screwdriver Set
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Socket Set
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Allen Key Set
Safety Equipment
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Gas Monitor & Charger?
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Harness?
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Safety Rope?
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Man riding Winch?
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Fall Arrest System?
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Escape set?
Computer Based Equipment
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Computer PAT Tested
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Mouse & Keyboard Working Without Keys Missing
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Monitors Working, PAT Tested
Surveying Equipment
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Minimum 200m Of Camera Cable + In Good Condition
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150mm Light Head
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225mm Light Head
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350mm Light Head
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150 Wheel Set (small Green)
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225mm Wheel Set with Seals In Place
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300mm Wheel Set
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350mm Wheel Set
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Spare Bulbs + Bolts
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Nematic Wheel Set (heavy)
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Push-Rod Minimum 30m
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Link Cable
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Ex Rated
Miscellaneous
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First Aid Kit In Easy To Find Location
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Eye Wash?
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Fire Extinguisher, In Date + Unused
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Hand Washing Facility's With Hot Running Water?
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Open Manholes Protected?
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Optimise Inducted
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Confined Space Trained
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MSCC4 Sewer Classification
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Street Works
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Thames Water Pink Card
Questions For Operator
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Please Explain Your Emergency Proceedure.
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All light units working and suitable bulb types used, Lighting to be able to follow pan & tilt where appropriate.
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Does pan and tilt work correctly (fully rotate)
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Does camera unit sit in sewer correctly
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Is the correct lighting fitted to provide adequate Illumination
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Picture quality suitable & in focus
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Video footage in correct format
Comments
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