CDM form

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

Plan

• Contact details of architect or principal designer

• Description of works

• Is there anything the client has made you aware of?

  Yes

  No

  N/A

• Please advise of any issues raised by the client

• Start date

  Date

• Estimated completion date

  Date

• Are there toilet, wash and welfare facilities

  Yes

  No

  N/A

• Please advise of remote welfare facilities

Working together

• Are there other people on site?

  Yes

  No

  N/A

• Please enter name and numbers of persons on site

• Who is the principal contractor?

• How will you keep everyone updated during the job

Falls from height

• 
  
  •Make sure ladders are at the correct angle and are secure
  
  •Prevent people and materials falling from roofs, gable ends, working platforms and other open edges using guard rapid mid rails and toe boards
  
  

• Are there any hazards present

  Yes

  No

  N/A

• Add media

  Media

• Have control measures been implemented.

  Yes

  No

  N/A

• Please advise of control measures

• Add media

  Media

Collapse of excavations

• •Shore excavations; either cover or barrier excavations to stop people and plant falling in

• Are there any hazards present?

  Yes

  No

  N/A

• Have control measures been implemented. If so what are these measure

  Yes

  No

  N/A

Collapse of structures

• • Support structures (such as walls, beams, chimney breasts and roofs) with props; ensure props are installed by a competent person

• Are there any hazards present?

  Yes

  No

  N/A

• Add drawing

  Drawing

• Have control measures been implemented. If so what are these measure

  Yes

  No

  N/A

Exposure to building dust

• •Prevent dust by using wet cutting and vacuum extraction on tools; use a vacuum cleaner rather than sweeping; use a suitable, well-fitting mask

• Are there any hazards present?

  Yes

  No

  N/A

• Have control measures been implemented. If so what are these measure

  Yes

  No

  N/A

Exposure to Asbestos

• •If you suspect that asbestos might be present, don’t start work until a demolition/refurbishment survey has been carried out •Make sure everyone on the site is aware of the results

• Have you reviewed the asbestos report?

  Yes

  No

  N/A

• Are there any hazards present?

  Yes

  No

  N/A

• Have control measures been implemented. If so what are these measure

  Yes

  No

  N/A

• Is it considered safe to commence work?

  Yes

  No

  N/A

Activities that require supervision

• Who will be supervising?

• Are there any hazards present?

  Yes

  No

  N/A

• Have control measures been implemented. If so what are these measure

  Yes

  No

  N/A

Electricity

• •Turn electricity supply and other services off before drilling into walls. Do not use excavators or power tools near suspected buried services

• Are there any hazards present?

  Yes

  No

  N/A

• Have control measures been implemented. If so what are these measure

  Yes

  No

  N/A

Risks to members of the public, the client and others

• • Keep the site secure to prevent unauthorised access; net scaffolds, use rubbish chutes

• Are there any hazards present?

  Yes

  No

  N/A

• Have control measures been implemented. If so what are these measure

  Yes

  No

  N/A

Other hazards

• Are there any other hazards on site

  Yes

  No

  N/A