CFH Field Services : In-Progress & Post Build Quality

• Site conducted

  Select

• S Number (please ensure this aligns with SalesForce format)

• Prepared by

• 

• Document No. QMSF-PR-08-04 Version 1 Revision 0 Dated 11/12/2019

• (Format:- City name - Job Pack / PN Number) E.g Aberdeen S12345 Always insert City name and Job Pack / PN number if known

• CityFibre Holdings Ltd, 15 Bedford St, London, WC2E 9HE

• Conducted on

  Date

Location

• Location
  Address

• Who is the Principal Contractor?

  Select

Reference materials (Streetworks Code of Practice etc.)

• Code of Practice (Red Book)
  https://cityfibreholdings.sharepoint.com/IMS/OHSMS/Shared%20Documents/Compliance%20Department%20Folders/IAuditor%20Reference%20Matrials/safety-at-streetworks.pdf

• CDM Code of Practice
  https://cityfibreholdings.sharepoint.com/IMS/OHSMS/Shared%20Documents/Compliance%20Department%20Folders/IAuditor%20Reference%20Matrials/l153(1).pdf

• CityFibre Fibre Specification Document
  https://cityfibreholdings.sharepoint.com/IMS/OHSMS/Shared%20Documents/Compliance%20Department%20Folders/IAuditor%20Reference%20Matrials/CF-NOD-SFI01%20-%20Fibre%20Specification.docx?d=wc41be78482c44d1eb56b968a21e799cf

• CityFibre Civils Specification Document
  https://cityfibreholdings.sharepoint.com/IMS/OHSMS/Shared%20Documents/Compliance%20Department%20Folders/IAuditor%20Reference%20Matrials/CF-NOD-SCI01%20Civils%20Specification%20FINAL.DOCX?d=wd74a900ece7f4ea7a299ef8fe7e99a04

• Contractor Monitoring Risk Assessment
  https://cityfibreholdings.sharepoint.com/IMS/OHSMS/Shared%20Documents/3.%20%20OHSM%20Risk%20Assessments/OHSF%E2%80%93PR-03-01-019%20RA%20Monitoring%20Contractor%20Work%20Sites.doc?d=wc53e3603bd7a41198b86334459838ff2

• SROF (Reinstatement specification Highways)
  https://cityfibreholdings.sharepoint.com/IMS/OHSMS/Shared%20Documents/Compliance%20Department%20Folders/IAuditor%20Reference%20Matrials/SROF%20Scotland.pdf

Inspection

• What type of audit are you conducting today

  Select

This form is to be used at all time when conducting a Civils Excavation Audit.

• Confirm what type of Audit are you doing today?

  Select

• which area are you conducting this inspection?

  Carriageway

  Footway / Verge

Expected Tools and Equipment

• (please provide a photograph and any relevant information).

• Cat and Genny

  Yes

  No

  N/A

• PVC Tape

  Yes

  No

  N/A

• Approved Tube Cutters (N/A only if tubes have been pre-cut off-site)

  Yes

  No

  N/A

• Tape Measure

  Yes

  No

  N/A

Process

• Is the surface adjacent to the excavation clear of excavated material?

  Yes

  No

• Carriageway depth of cover?

  Select Type 3/4 at minimum depth of cover 450mm Type 1/2 at minimum depth of cover 600mm

  • Type 3/4 at minimum depth of cover 450mm
  • Type 1/2 at minimum depth of cover 600mm

• Please provide a photo of the depth of cover

  Media

• Is there 20mm sand bedding present?

  Yes

  No

  Not Witnessed

• Is there 50mm sand cover present?

  Yes

  No

  Not Witnessed

• Is marker tape placed in trench?

  Yes

  No

  Not Witnessed

• Is the toby box set in concrete and flush with surface?

  Yes

  No

  N/A

• Is there 300mm of subscribers tube within the toby box & fitted with approved end cap?

  Yes

  No

  N/A

Material used for backfill/compaction

• What material is being used to backfill/ compact?

  Select Imported Type One Recycled material As dug excavated material Concrete Foam Concrete Not Witnessed

  • Imported Type One
  • Recycled material
  • As dug excavated material
  • Concrete
  • Foam Concrete
  • Not Witnessed

Number of compaction passes

• Wide foot upright Wacker- suggested number of passes for every 150mm compacted lift thickness = 8
  Narrow foot upright Wacker -suggested number of passes for every 150mm compacted lift thickness = 4

• What type of upright wacker are they using?

  Wide Foot upright Wacker

  Narrow Foot upright Wacker

  None on Site
No. of compacted lift/layers observed

• Number of passes/layers observed during compaction

  8 or more

  Less than 8

  Not Witnessed
No. of compacted lift/layers observed

• Number of passes/layers observed during compaction

  4 or more

  Less than 4

  Not Witnessed

• Clegg reading 4th drop expected value 30

  Yes

  No

  N/A

• Is the material suitable for use?

  Yes

  No

• Are all kerbs replaced including bedding and backing?

  Yes

  No

  N/A

Cavity depth for reinstatement

• Is it an Interim reinstatement?

  Yes

  No

  N/A

• Modular paving cavity depth should match the existing

  Yes

  No

  N/A

• Photograph required

  Media

• Bituminous cavity depth minimum for type 4 flexible road 100mm

  Yes

  No

  N/A

• Please provide a photo

  Media

• Bituminous cavity depth minimum for type 3 flexible road 190mm

  Yes

  No

  N/A

• Please provide a photo

  Media

• Bituminous cavity depth minimum for type 2 flexible road 285mm

  Yes

  No

  N/A

• Please provide a photo

  Media

• Bituminous cavity depth minimum for type 1 flexible road 320mm

  Yes

  No

  N/A

• Please provide a photo

  Media

Site Clean up

• Road markings replaced

  Yes

  No

  N/A

• Site swept clean

  Yes

  No

  N/A

Tools and Equipment on Site

• Cat and Genny

  Yes

  No

• PVC Tape

  Yes

  No

• Approved Tube Cutters (N/A only if tubes have been pre-cut off-site)

  Yes

  No

  N/A

• Tape Measure

  Yes

  No

Process

• Are tubes/looms fitted with end caps and bound together utilising PVC insulation tape at 1m intervals to ensure they will lay within the trench and individual tubes lie parallel with each other without excessive intertwining?

  Yes

  No

  N/A

• Are the tubes/blown fibre tubes made up on-site or pre-loomed at another location?

  Pre-loomed

  on-site

• Is the surface clear of excavated material?

  Yes

  No

  N/A

• Is the depth of cover @ 250mm minimum?

  Yes

  No

  Not Witnessed

• Please provide a photo of the depth of cover

  Media

• Is there 20mm Sand Bedding present?

  Yes

  No

  Not Witnessed

• Is there 50mm Sand Cover present?

  Yes

  No

  Not Witnessed

• Is there Marker tape placed in the trench?

  Yes

  No

  Not Witnessed

• Is the toby box set in and flush with the surrounding surface and in accordance with CF specification? (If not present in the section you are auditing, please use previous days construction work.)

  Select Yes No No toby box in the section being audited

  • Yes
  • No
  • No toby box in the section being audited

• Is there 300mm of subscribers tube within the toby box & fitted with approved end cap? (Please lift lid and take image. If not present in the section you are auditing, please use previous days construction work.)

  Select Yes No No toby box in the section being audited

  • Yes
  • No
  • No toby box in the section being audited

Material used for backfill/compaction

• What material is being used to backfill/ compact

  Select Imported Type One Recycled material As dug excavated material Concrete Foam Concrete Not Witnessed

  • Imported Type One
  • Recycled material
  • As dug excavated material
  • Concrete
  • Foam Concrete
  • Not Witnessed

• Is this for verge backfill?

  Yes

  No

• Is the material suitable for reuse?

  Yes

  No

• Is the material suitable for use?

  Yes

  No

Number of compaction passes

• Wide foot upright Wacker- suggested number of passes for every 150mm compacted lift thickness = 8
  Narrow foot upright Wacker -suggested number of passes for every 150mm compacted lift thickness = 4

• What type of upright wacker are they using?

  Wide Foot upright Wacker

  Narrow Foot upright Wacker

  None on Site
No. of compacted lift/layers observed

• Number of passes/layers observed during compaction

  8 or more

  Less than 8

  Not Witnessed
No. of compacted lift/layers observed

• Number of passes/layers observed during compaction

  4 or more

  Less than 4

  Not Witnessed

• Clegg reading 4th drop expected value 22

  Yes

  No

  N/A

• Are all kerbs replaced including bedding and backing?

  Yes

  No

  N/A

Cavity depth for reinstatement

• What is the surface type?

  Bituminous

  Modular

  Concrete

  Verge

• What is the bituminous cavity depth?

  60mm to 80mm

  Less than 60mm

  80mm or more

• Please provide a photo of the cavity depth

  Media

• Modular paving cavity depth should match the existing

  Yes

  No

  N/A

• Concrete surfacing should match existing minimum 100mm

  Yes

  No

  N/A

• Site swept clean

  Yes

  No

  N/A

• What surface is being reinstated?

  Concrete

  Bituminous

  Verge

  Modular & Paving

• which area are you conducting this inspection?

  Footway

  Carriageway Type 4

  Carriageway Type 3

Expected Tools and Equipment

• Tape Measure

  Yes

  No

• Upright Wacker Wide Foot

  Yes

  No

• Pedestrian plate

  Yes

  No

  N/A

• Vibrating roller

  Yes

  No

  N/A

• Hand tamper

  Yes

  No

• Non corrosive tool cleaner

  Yes

  No

• Edge sealant

  Yes

  No

• Watering can fitted with a rose

  Yes

  No

• Temperature gauge

  Yes

  No

Process

• Type 4 carriageway 100mm bituminous material required

  Cavity depth 100mm or more

  Cavity depth less than 100mm

• Has the team checked the cavity depth?

  Yes

  No

• Please provide a photo of the cavity depth

  Media

• Has the team trimmed the reinstatement correctly to SROH?

  Yes

  No

• Has the team re-compacted the sub-base?

  Yes

  No

• Has the team applied edge sealant to top 100mm of bituminous material and exposed kerbs and ironwork?

  Yes

  No

• Binder course compacted lift thickness @ 60mm recommended number of passes 7 using upright wacker

  7 or more complete passes

  Less than 7

• Surface course compacted lift thickness @ 40mm recommended number of passes 10 using vibrating roller

  10 or more

  Less than 10

• have the road markings been replaced?

  Yes

  No

  N/A

• Has the site been swept clean?

  Yes

  No

• Please provide a photograph of site

  Media

Expected Tools and Equipment

• Tape Measure

  Yes

  No

• Upright Wacker Wide Foot

  Yes

  No

  N/A

• Upright Wacker Narrow Foot

  Yes

  No

  N/A

• Pedestrian plate

  Yes

  No

  N/A

• Vibrating roller

  Yes

  No

• Hand tamper

  Yes

  No

  N/A

• Non corrosive tool cleaner

  Yes

  No

• Edge sealant

  Yes

  No

• Watering can fitted with a rose

  Yes

  No

• Temperature gauge

  Yes

  No

Process

• Has the team checked the cavity depth?

  Yes

  No

• Please provide Image of the cavity depth

  Media

• Has the team trimmed the reinstatement to SROH/R correctly?

  Yes

  No

• Has the team re-compacted the sub-base?

  Yes

  No

• Has the team applied edge sealant to top 100mm of bituminous material and exposed kerbs and ironwork?

  Yes

  No

• Is the reinstatement Base/Surface course or All Surface course?

  Base/Surface Course

  All Surface Course

• Reinstatement cavity depth

  80-90mm Optimum

  Less than 80mm

  More than 90mm

• 20mm Binder course material compacted lift thickness @ 50mm recommended number of passes 6 using upright wide foot wacker

  6 or more complete passes

  less than 6

  N/A

• 20mm Binder course material compacted lift thickness @ 50mm recommended number of passes 3 using upright narrow foot wacker

  3 or more complete passes

  less than 3

  N/A

• Reinstatement cavity depth

  60-70mm Optimum

  Less than 60mm

  More than 70mm

• 6mm Binder course material compacted lift thickness @ 30mm recommended number of passes 5 using upright wide foot wacker

  5 or more complete passes

  5 or less

  N/A

• 6mm Binder course material compacted lift thickness @ 30mm recommended number of passes 3 using upright narrow foot wacker

  3 or more complete passes

  less than 3

  N/A

• Surface course compacted lift thickness @ 30mm recommended number of passes 10 using vibrating roller

  10 or more

  Less than 10

• Is the site swept clean?

  Yes

  No

• Please Provide a photo of the site

  Media

Expected Tools and Equipment

• Tape Measure

  Yes

  No

• Upright Wacker Wide Foot

  Yes

  No

• Pedestrian plate

  Yes

  No

  N/A

• Vibrating roller

  Yes

  No

• Hand tamper

  Yes

  No

• Non corrosive tool cleaner

  Yes

  No

• Edge sealant

  Yes

  No

• Watering can fitted with a rose

  Yes

  No

• Temperature gauge

  Yes

  No

Process

• Type 3 carriageway 190mm bituminous material required

  Cavity depth 190mm or more

  Cavity depth less 190mm

• Has the team checked the cavity depth?

  Yes

  No

• Please provide a photo of the cavity depth.

  Media

• Has the team trimmed the reinstatement correctly to SROH?

  Yes

  No

• Has the team re-compacted the sub-base?

  Yes

  No

• Has the team applied edge sealant to top 100mm of bituminous material and exposed kerbs and ironwork?

  Yes

  No

• Binder course compacted lift thickness @ 60mm recommended number of passes 7 using upright wacker

  7 or more complete passes

  Less than 7

• Binder course additional lifts will be required

Additonal Lifts

• Binder course compacted lift thickness @ 60mm recommended number of passes 7 using upright wacker

  7 or more complete passes

  Less than 7

• Surface course compacted lift thickness @ 40mm recommended number of passes 10 using vibrating roller

  10 or more

  Less than 10

• have the road markings been replaced?

  Yes

  No

  N/A

• Has the site been swept clean?

  Yes

  No

• Please provide a photograph of the site

  Media

• which area are you conducting this inspection?

  Yes

  No

• Is the sub-base material matching the existing in type and to a minimum thickness of 150mm

  Yes

  No

  N/A

• Has the adjacent concrete cracked as a result of the excavation operation.

  Yes

  No

• Has the damaged area of the slab been removed and included within the area to be reinstated?

  Yes

  No

• Have all 300mm trim-lines been included within the reinstatement?

  Yes

  No

• Has the slip membrane been replaced

  Yes

  No

  N/A

  Not Witness

• Has all reinforcement been replaced correctly/where required

  Yes

  No

  N/A

  Not Witness

• Is the concrete mixed to the correct strength

  Yes

  No

  Not Witnessed

• Does the concrete match the existing thicknesss (minimum 100mm)

  Yes

  No

  Not Witnessed

• Have all edging/road kerbs removed or damaged by our works been replaced correctly

  Yes

  No

  N/A

• Have all expansion/warping joints removed by our works been replaced

  Yes

  No

  N/A

• Does the texture and finish match the existing

  Yes

  No

• Is there a minimum of 150mm reinstatement around the CF toby box

  Yes

  No

  N/A

• Is the fillet to the surround of the CF chamber/cabinet reinstated correctly

  Yes

  No

  N/A

• Is the sub-base material matching the existing in type and to a minimum thickness of 100mm

  Yes

  No

  Not Witnessed

• Has the adjacent concrete cracked as a result of the excavation operation.

  Yes

  No

• Has the damaged area of the slab been removed and included within the area to be reinstated

  Yes

  No

• Have all 150mm trim-lines been included within the reinstatement

  Yes

  No

• Is the concrete mixed to the correct strength

  Yes

  No

  Not Witnessed

• Does the concrete match the existing thicknesss (minimum 100mm)

  Yes

  No

• Have all edging/road kerbs removed or damaged by our works been replaced correctly

  Yes

  No

  N/A

• Have all expansion/warping joints removed by our works been replaced correctly

  Yes

  No

  N/A

• Does the texture and finish match the existing

  Yes

  No

  N/A

• Is there a minimum of 100mm reinstatement around the CF toby box

  Yes

  No

  N/A

• Is the fillet to the surround of the CF chamber/cabinet reinstated correctly

  Yes

  No

  N/A

• Has any structural courses supporting the adjacent construction road/footway removed by our works been replaced

  Yes

  No

  N/A

  Not Witness

• Has the top 200mm of topsoil been removed and replaced

  Yes

  No

  Not Witnessed

• Has a minimum 100mm of topsoil been used to reinstate

  Yes

  No

  Not Witnessed

• Have the grassed areas been reinstated using the original turf, replacement turf or will they be seeded

  Yes

  No

  N/A

• Please Comment

• Where grassed areas have been mown, the reinstated surface must be demonstrably free from stones greater than 20 mm nominal size

  Yes

  No

  N/A

• Please Comment

• Have any signs/verge markers removed by our works been replaced correctly

  Yes

  No

  N/A

  Not Witness

• Have all edging/road kerbs removed or damaged by our works been replaced correctly

  Yes

  No

  N/A

• Is the fillet to the surround of the CF chamber/cabinet reinstated correctly

  Yes

  No

  N/A

• Is the sub-base material matching the existing in type and to a minimum thickness of 100mm

  Yes

  No

  Not Witnessed

• Is the bedding material matching the existing in thckness and type

  Yes

  No

  Not Witnessed

• Have any damaged modules/paving been replaced with the same type, colour and thickness

  Yes

  No

  Not Witnessed

• Does the permanent reinstatement of modules/paving include all modules/paving, which are situated within or extend beyond the effective width of the reinstatement

  Yes

  No

• Is the layout of modules/paving match that of the existing pattern

  Yes

  No

• Has Kiln dried sand been applied and vibrated in using a plate compactor fitted with a neoprene pad

  Yes

  No

  N/A

  Not Witness

• Are all moduls/paving laid within tollerance to the surroundng adjoining surfaces with no moduls/paving rocking

  Yes

  No

• Have all infills between modules/paving and kerbs been filled to the full depth including matching existing material type /colour

  Yes

  No

  N/A

• Is there a maximum fillet of 50mm around the CF toby

  Yes

  No

  N/A

• Is the fillet to the surround of the CF chamber/cabinet reinstated correctly

  Yes

  No

  N/A

• Have all existing fillets disturbed by our works been replaced

  Yes

  No

  N/A

• Have all edging/road kerbs removed or damaged by our works been replaced correctly

  Yes

  No

  N/A

• What is the status of work?

  In Progress

  Post Build

Cable Pulling Process

• Has correct Subduct been installed for cable size?

  Yes

  No

  N/A

• Has Subduct been coupled through as per specification?

  Yes

  No

  N/A

• Has back rope been installed?

  Yes

  No

  N/A

• Has cable been labelled correctly?

  Yes

  No

  N/A

• Cables and tube/sub-duct correctly labelled?

  Yes

  No

  N/A

• Is the appropriate cable being installed?

  Yes

  No

  N/A

• What is the cable size?

  Select 12 24 36 (Overhead) 48 72 96 144 288 432

  • 12
  • 24
  • 36 (Overhead)
  • 48
  • 72
  • 96
  • 144
  • 288
  • 432

• Has sufficient cable been left as per build plan?

  Yes

  No

  N/A

• Are cable ties cut flush with no sharp edges?

  Yes

  No

  N/A

• Has the cable been left neatly coiled and where applicable attached to bearers?

  Yes

  No

  N/A

• Is there any visible damage that may compromise the integrity of the cable?

  Yes

  No

  N/A

• Has subduct been labelled correctly

  Yes

  No

  N/A

• Has a winch been used? (If yes, please add photo and service date to notes)

  YES

  NO

• Was A Swivel / Stocking Used

  YES

  NO

• What Size Fuse Was Used / Was It Correct Size

  YES

  NO

• Have They Used Roller For Protection

  YES

  NO

• Is The Correct Subduct Installed (Size)

  YES

  NO

• Has Subduct Been Fixed To The Bearers Correctly

  YES

  NO

• Has Site Been Set Up With Chapter 8

  YES

  NO

• Is Pedestrian Walk Way Available

  YES

  NO

• Has Cable Been Labelled

  YES

  NO

• Has 25M Coil Been Left For Jointing Purposes

  YES

  NO

• Has Correct Subduct Connector Been Used For Connections

  YES

  NO

• Has Back Rope Been Installed For Next Use

  YES

  NO

• Any other Comments (please attach photos)

• What is the status of work?

  In Progress

  Post Build

Splice Joint

• Has Subduct been installed on incoming/ outgoing side?

  Yes

  No

  N/A

• Has Subduct been cut correctly?

  Yes

  No

  N/A

• Cable size?

  Select 12 24 36 (Overhead) 48 72 96 144 288 432

  • 12
  • 24
  • 36 (Overhead)
  • 48
  • 72
  • 96
  • 144
  • 288
  • 432

• Has incoming/outgoing cable been labelled correctly?

  Yes

  No

  N/A

• Has sufficient cable been left to allow for safe jointing practices?

  Yes

  No

  N/A

• Has outgoing cable been installed?

  Yes

  No

  N/A

• Has sufficient cable been left to allow for safe jointing practices?

  Yes

  No

  N/A

• Is the correct join inclosure been fitted/installed?

  Yes

  No

  N/A

• Are cable glands correctly fitted and secure?

  Yes

  No

  N/A

• Are the fibres prepped and dressed correctly?

  Yes

  No

  N/A

• Has cable been left neatly coiled and free of existing cables?

  Yes

  No

  N/A

• Is Cable bend radius ok?

  Yes

  No

  N/A

• Please provide a photo

  Media

• Is there any visible damage that may compromise the integrity of the cable?

  YES

  NO

• Has debris been removed?

  YES

  NO

• Is Iso Alcohol Availabe To Clean Fibres

  YES

  NO

• Does The Person Carry A Sharps Bin

  YES

  NO

• Are The Fibres Left And Wrapped To Adequate Length

  YES

  NO

• Are The Spare Fibres Stored Correctly

  YES

  NO

• Has The Tray Been Labelled

  YES

  NO

• Has Heat Proof Foil Been Used

  YES

  NO

• Is The Cable Labelled Correctly

  YES

  NO

• Has Jointing Been Left Clean And Tidy For Next Engineer

  YES

  NO

• Are The Fibres Being Tested

  YES

  NO

• Has Port Entry Been Completed Correctly

  Yes

  No

  N/A

• Splicer Calibration Date

  Date

• Cleaver Service Date

  Date

• OTDR Callibration Date

  Date

• Please enter the Electrode Splicing Count Number

Splice Joint

• Has Subduct been installed on incoming/ outgoing side?

  Yes

  No

  N/A

• Has Subduct been cut correctly?

  Yes

  No

  N/A

• Cable size?

  Select 12 24 36 (Overhead) 48 72 96 144 288 432

  • 12
  • 24
  • 36 (Overhead)
  • 48
  • 72
  • 96
  • 144
  • 288
  • 432

• Has incoming/outgoing cable been labelled correctly?

  Yes

  No

  N/A

• Has sufficient cable been left to allow for safe jointing practices?

  Yes

  No

  N/A

• Has sufficient cable been left to allow for safe jointing practices?

  Yes

  No

  N/A

• Is the correct join inclosure been fitted/installed?

  Yes

  No

  N/A

• Are cable glands correctly fitted and secure?

  Yes

  No

  N/A

• Has cable been left neatly coiled and free of existing cables?

  Yes

  No

  N/A

• Is Cable bend radius ok?

  Yes

  No

  N/A

• Please provide a photo

  Media

• Is there any visible damage that may compromise the integrity of the cable?

  YES

  NO

• Has debris been removed?

  YES

  NO

• What is the status of work?

  In Progress

  Post Build

Internal work

• Has the Asbestos register available and up-to-date?

  Yes

  No

  N/A

• Duct entry point – Is the gas seal fitted?

  Yes

  No

  N/A

• Drill hole – Has Fire sealant been used?

  Yes

  No

  N/A

• Have holes been drilled correctly with no damage to the surrounding area?

  Yes

  No

  N/A

• Correct cable used i.e. CPR rated LSZH for internal use.

  Yes

  No

  N/A

• Has dust & debris been cleaned up from area?

  Yes

  No

  N/A

• If Breakout Box fitted is it the correct IP rating?

  Yes

  No

  N/A

• Is cable in correct trunking as per pack, both external & internal?

  Yes

  No

  N/A

• Is cable routed as per pack & wayleave?

  Yes

  No

  N/A

• Is tray in the correct position in cabinet as per pack?

  Yes

  No

  N/A

• Have tray been correctly ID’d?

  Yes

  No

  N/A

• Ports clear & easily accessible

  Yes

  No

  N/A

• Port protectors in ports.

  Yes

  No

  N/A

• Sharps & debris removed from the works area & hoovered?

  Yes

  No

  N/A

• Additional Comments

• Would you like to highlight any good practice?

  Yes

  No

• Who would you like to highlight?

  Contractor / Gang

  Individual

  Other

• If answer is other, please specify.

• Please name the group / individual you would like to highlight

• Which category best describes the good practice? Categories TBC

  Select

• Please describe the category of the work being recognised.

• Please give a description of the practice you have observed and would like recognised.

• Please provide the name of the Supervisor or Sub-Contractor.

• Please provide the name of the Gang Leader.

All personnel conducting site audits and inspections must ensure that all findings are recognised by the Contactor lead person on site (They do not have to agree the findings but must acknowledge your audit)

• Contractor Signature of recognition of findings

  Sign

• Ensure all actions have been assigned and the senior contractor has provided signature recognising findings

  Yes

  No

  N/A

• Auditor to sign to confirm completion of the audit.

  Sign