Title Page

  • Site conducted

  • images.png
  • OHSF-PR-08-03 Version 1 Revision 1 Dated 21/01/2021

  • Conducted on

  • S Reference

  • Team Leader/ Team name

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

  • Location
  • Prepared by

  • Before Works Commence Site Photo

Safety Check - If you answer 'No' to any of the following 3 questions, end the audit and take appropriate action.

  • Please answer the following 3 questions based on your dynamic risk assessment on arrival at the site. If you answer 'No' to any of the following questions please explain this in the free text field which appears with a 'No' answer, end the audit and take the appropriate action.

  • Is it safe for you to conduct this audit?

  • Please explain why and what action you have taken as a result.

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

  • Please explain why and what action you have taken as a result.

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

  • Please explain why and what action you have taken as a result.

Health & Safety Questions

Health & Safety Questions

  • The following Health & Safety questions are unweighted and do not impact the overall score of the audit. The purpose of the section is to ensure that Health & Safety remains a priority for the entirety of the CityFibre build process. Please utilise the notes and media features to raise any H&S concern whether they are related to these questions or not. Please engage your local SHEQ advisor should you have any concerns.

SLG (is it immediately obvious to pedestrians what is happening, and what is expected of them)

  • Chapter 8 : https://cityfibreholdings.sharepoint.com/:b:/r/SalesAndOperations/Shared%20Documents/Procurement/City%20Folders%20-%20Contract%20Management/Newcastle/8.0%20Working%20Folder/Useful%20Documents/Methods%20Of%20Measurement/Chapter%208/Traffic%20Signs-Manual-Chapter-08.pdf?csf=1&web=1&e=7RMmno

  • Is the SLG set up compliant with Chapter 8?

  • Please raise an action for site to be made safe within 2 hours and ensure rectification is evidenced (by staying on site or providing photo evidence on closure of action).

PPE

  • Is adequate PPE being used for the task being undertaken?

Traffic Management (is it immediately obvious to traffic what is happening, and what is expected of them)

  • Is sufficient traffic management in place for the works being undertaken?

Strike Avoidance

  • Is there a fully operational, calibrated, CAT & Genny on site, being used appropriately?

  • Please raise an action for site to be made safe within 2 hours and ensure rectification is evidenced (by staying on site or providing photo evidence on closure of action).

Documentation

  • Is there a valid permit, site specific risk assessment and in-date drawings on site?

  • Please raise an action for site to be made safe within 2 hours and ensure rectification is evidenced (by staying on site or providing photo evidence on closure of action).

In Progress Quality Inspection

  • Are the operatives on site in possession of a valid NOPS card?

  • Are the operatives on site accredited to carry out the task being undertaken?

  • Which Audit/Inspection are you completing today?

  • which area are you conducting this inspection?

Expected Tools and Equipment

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

  • Cat and Genny

  • Approved Tube Cutters?

  • Is a deburring tool available on site?

  • Tape Measure

Process

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

  • Carriageway depth of cover?

  • Please provide a photo of the depth of cover

  • Is there 20mm sand bedding present?

  • Is there 50mm sand cover present?

  • Is marker tape placed in trench?

Material used for backfill/compaction

  • What material is being used to backfill/ compact?

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?

  • No. of compacted lift/layers observed
  • Number of passes/layers observed during compaction

  • No. of compacted lift/layers observed
  • Number of passes/layers observed during compaction

  • Is the material suitable for use?

Cavity depth for reinstatement

  • Is it an Interim reinstatement?

  • Modular paving cavity depth should match the existing

  • Photograph required

  • What type of road are you auditing?

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

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

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

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

Site Clean up

  • All NRSWA equipment removed from site

  • Site swept clean

  • Photo capture of closed site as complete

Tools and Equipment on Site

  • Cat and Genny

  • PVC Tape

  • Approved Tube Cutters?

  • Is a deburring tool available on site?

  • Tape Measure

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?

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

  • Is the surface clear of excavated material?

  • Is the depth of cover @ 250mm minimum?

  • Please provide a photo of the depth of cover

  • Is there 20mm Sand Bedding present?

  • Is there 50mm Sand Cover present?

  • Is there Marker tape placed in the trench?

  • Is the toby box set in and flush with the surrounding surface and in accordance with CF specification?

  • Is there 300mm of subscribers tube within the toby box? (Please lift lid and take image.)

  • Has an end cap been fitted?

Material used for backfill/compaction

  • What material is being used to backfill/ compact

  • Is this for verge backfill?

  • Is the material suitable for reuse?

  • Is the material suitable for use?

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?

  • No. of compacted lift/layers observed
  • Number of passes/layers observed during compaction

  • No. of compacted lift/layers observed
  • Number of passes/layers observed during compaction

  • Clegg reading 4th drop expected value 22

  • Are all kerbs replaced including bedding and backing?

Cavity depth for reinstatement

  • What is the surface type?

  • What is the bituminous cavity depth?

  • Please provide a photo of the cavity depth

  • Modular paving cavity depth should match the existing

  • Concrete surfacing should match existing minimum 100mm

  • Site swept clean

  • What surface is being reinstated?

  • which area are you conducting this inspection?

Expected Tools and Equipment

  • Tape Measure

  • Upright Wacker Wide Foot

  • Pedestrian plate

  • Vibrating roller

  • Hand tamper

  • Non corrosive tool cleaner

  • Edge sealant

  • Watering can fitted with a rose

  • Temperature gauge

Process

  • Type 4 carriageway 100mm bituminous material required

  • Has the team checked the cavity depth?

  • Please provide a photo of the cavity depth

  • Has the team trimmed the reinstatement correctly to SROH?

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

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

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

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

  • have the road markings been replaced?

  • Has the site been swept clean?

  • Please provide a photograph of site

Expected Tools and Equipment

  • Tape Measure

  • Pedestrian plate

  • Vibrating roller (Plate)

  • Hand tamper

  • Non corrosive tool cleaner

  • Edge sealant

Process

  • Has the team checked the cavity depth?

  • Please provide Image of the cavity depth

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

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

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

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

  • Reinstatement cavity depth

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

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

  • Reinstatement cavity depth

  • 6mm-15/10 Binder course material compacted lift thickness @ 30mm recommended number of passes 5 using upright Wide foot wacker

  • 6mm-15/10 Binder course material compacted lift thickness @ 30mm recommended number of passes 5 using upright narrow foot wacker

  • Surface course compacted lift thickness @ 30mm recommended number of passes 10 using vibrating roller. Or in the case of a deteriorated/distressed are, choose Driveway Plate.

  • Please confirm the type of Driveway Plate in use.

  • Please insert the number of passes witnessed.

  • Is the site swept clean?

  • Please Provide a photo of the site closed down

Expected Tools and Equipment

  • Tape Measure

  • Upright Wacker Wide Foot

  • Pedestrian plate

  • Vibrating roller

  • Hand tamper

  • Non corrosive tool cleaner

  • Edge sealant

  • Watering can fitted with a rose

  • Temperature gauge

Process

  • Type 3 carriageway 190mm bituminous material required

  • Has the team checked the cavity depth?

  • Please provide a photo of the cavity depth.

  • Has the team trimmed the reinstatement correctly to SROH?

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

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

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

  • Binder course additional lifts will be required

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

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

  • have the road markings been replaced?

  • Has the site been swept clean?

  • Please provide a photograph of the site

  • which area are you conducting this inspection?

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

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

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

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

  • Has the slip membrane been replaced

  • Has all reinforcement been replaced correctly/where required

  • Is the concrete mixed to the correct strength

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

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

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

  • Does the texture and finish match the existing

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

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

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

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

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

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

  • Is the concrete mixed to the correct strength

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

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

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

  • Does the texture and finish match the existing

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

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

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

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

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

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

  • Please Comment

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

  • Please Comment

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

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

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

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

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

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

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

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

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

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

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

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

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

  • Have all existing fillets disturbed by our works been replaced

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

Sign off

  • Would you like to highlight any good practice?

  • Who would you like to highlight?

  • 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

  • Please describe the category of the work being recognised.

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

  • Auditor Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.