CHC/ F3 INSPECTION M&E WORKS

• JOB No.

• DESCRIPTION OF WORK CARRIED OUT.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• KEY STAFF

1. SITE ESTABLISHMENT

• 1.1 HEALTH AND SAFETY PLAN/REV

  Yes

  No

  N/A

• 1.2 EMERGENCY PROCEDURES, VISITOR INFORMATION, PRACTICE RUNS, OPERATIVE AWARENESS AND TRAINING

  Yes

  No

  N/A

• 1.3 EMERGENCY TELEPHONE NUMBERS

  Yes

  No

  N/A

2.0 SITE SAFETY MANAGEMENT SYSTEM

• 2.1 POLICY DOCUMENT AVAILABLE

  Yes

  No

  N/A

• 2.2 HEALTH AND SAFETY TRAINING

  Yes

  No

  N/A

• 2.3 INSURANCE IN DATE

  Yes

  No

  N/A

3.0 FIRE SAFETY

• 3.1 FLAMMABLES /EXPLOSIVES PRESENT.

  Yes

  No

  N/A

• 3.2 FIRE FIGHTING EQUIPMENT AVAILABLE

  Yes

  No

  N/A

• 3.3 HAS IT BEEN MAINTAINED, IS IT IN DATE?

  Yes

  No

  N/A

• 3.4 STAFF TRAINED IN USE?

  Yes

  No

  N/A

• 3.5 BRACKET WITH STRAP IN VAN?

  Yes

  No

  N/A

4.0 FIRST AID

• 4.1 FIRST AID KIT STOCKED?

  Yes

  No

  N/A

• 4.2 AWARE OF LOCATION?

  Yes

  No

  N/A

• 4.3 APP PERSON/TRAINED

  Yes

  No

  N/A

5.0 ACCIDENT PROCEDURES

• 5.1 ACCIDENT BOOK/REPORT FORM?

  Yes

  No

  N/A

• 5.2 HSE/EHO NOTIFICATION?

  Yes

  No

  N/A

• 5.3 REPORTING PROCEDURE AVAILABLE?

  Yes

  No

  N/A

• 5.4 STAFF AWARE?

  Yes

  No

  N/A

6.0 RISK ASSESSMENT /SSOW/METHOD STATEMENTS

• 6.1 PREPARED

  Yes

  No

  N/A

• 6.2 ADEQUATE?

  Yes

  No

  N/A

• 6.3 COMMUNICATED TO OTHER OPERATIVES?

  Yes

  No

  N/A

• 6.4 COMPLIED WITH?

  Yes

  No

  N/A

7.0 COSHH ASSESSMENT

• 7.1 SUBSTANCE ID PRIOR TO USE?

  Yes

  No

  N/A

• 7.2 ASSESSMENTS PREPARED

  Yes

  No

  N/A

• 7.3 COMMUNICATED VIA SSOW

  Yes

  No

  N/A

• 7.4 COMPLIED WITH?

  Yes

  No

  N/A

• 7.5 STORAGE IDENTIFIED BUND OR COSHH CABINET?

  Yes

  No

  N/A

• 7.6 SPILL KIT AVAILABLE?

  Yes

  No

  N/A

8.0 MANUAL HANDLING

• 8.1 ASSESSMENTS PREPARED?

  Yes

  No

  N/A

• 8.2 MECHANICAL OR AUTOMATED MEANS USED WERE POSSIBLE?

  Yes

  No

  N/A

• 8.3 STAFF TRAINED

  Yes

  No

  N/A

9.0 HOT WORKS

• 9.1 PERMIT TO WORK SYSTEM

  Yes

  No

  N/A

• 9.2 COMPETENT PERSONS

  Yes

  No

  N/A

• 9.3 EMERGENCY PROCEDURES IN PLACE BASED ON PERMIT?

  Yes

  No

  N/A

10.0 NOISE

• 10.1 ASSESSMENT PREPARED?

  Yes

  No

  N/A

• 10.2 RESULTS COMMUNICATED?

  Yes

  No

  N/A

• 10.3 PPE IDENTIFIED AND WORN

  Yes

  No

  N/A

11.0 PPE

• 11.1 IDENTIFIED FROM RISK ASSESSMENTS/SSOW

  Yes

  No

  N/A

• 11.2 TRAINED IN USE?

  Yes

  No

  N/A

• 11.3 CONFORMING ?

  Yes

  No

  N/A

• 11.4 PPE BOX AVAILABLE AND FULLY STOCKED?

  Yes

  No

  N/A

• 11.5 CORRECT STORAGE?

  Yes

  No

  N/A

12.0 WORKPLACE

• 12.1 ACCESS /EGRESS/SEGREGATION AS NECESSARY?

  Yes

  No

  N/A

• 12.2 EMERGENCY ACCESS MAINTAINED?

  Yes

  No

  N/A

• 12.3 PREVENTION OF OBSTRUCTIONS?

  Yes

  No

  N/A

• 12.4 HEATING

  Yes

  No

  N/A

• 12.5 SUFFICIENT LIGHTING?

  Yes

  No

  N/A

• 12.6 VENTILATION?

  Yes

  No

  N/A

• 12.7 BUILDING CONDITION?

  Yes

  No

  N/A

• 12.8 HOUSEKEEPING?

  Yes

  No

  N/A

13.0 WELFARE

• 13.1 TOILET /WASH FACILITIES INCLUDING HOT WATER?

  Yes

  No

  N/A

• 13.2 EATING AREA

  Yes

  No

  N/A

14.0 WORK AT HEIGHT

• 14.1 FALL PROTECTION

  Yes

  No

  N/A

• 14.2 ACCESS/EGRESS

  Yes

  No

  N/A

• 14.3 EDGE PROTECTION?

  Yes

  No

  N/A

• 14.4 LEADING EDGES?

  Yes

  No

  N/A

• 14.5 TRAINING?

  Yes

  No

  N/A

15.0 LADDERS,STEPLADDERS, PODIUMS,TOWER SCAFFOLDS

• 15.1 ID'S OF EQUIPMENT CHECKED ON SITE

  Yes

  No

  N/A

• 15.2 LADDER CHECK COMPLETED?

  Yes

  No

  N/A

• 15.3 SECURITY OF LADDER ?

  Yes

  No

  N/A

• 15.4 POSITION (BASE TO HEIGHT RATIO CHECKED)

  Yes

  No

  N/A

16.0 WORKPLACE INSPECTION

• 16.1 CARRIED OUT?

  Yes

  No

  N/A

• 16.2 RECORDED?

  Yes

  No

  N/A

17.0 ELECTRICAL SAFETY

• 17.1 PAT TESTING

  Yes

  No

  N/A

• 17.2 SYSTEM EXAMINATION

  Yes

  No

  N/A

• 17.3 USE OF RCD

  Yes

  No

  N/A

• 17.4 CABLE MANAGEMENT

  Yes

  No

  N/A

• 17.5 OVERHEAD/UNDERGROUND CABLES

  Yes

  No

  N/A

• 17.6 QUALITY OF TOOLS/LEADS/PLUGS

  Yes

  No

  N/A

18.0 WORK EQUIPMENT.

• 18.1 APPROPRIATE FOR USE?

  Yes

  No

  N/A

• 18.2 CONDITION?

  Yes

  No

  N/A

• 18.3 MAINTENANCE/CERTS?

  Yes

  No

  N/A

19.0 CONFINED SPACES.

• 19.1 COMPETENT PERSONS?

  Yes

  No

  N/A

• 19.2 EMERGENCY PROCEDURES?

  Yes

  No

  N/A

• 19.3 PERMIT TO WORK SYSTEM?

  Yes

  No

  N/A

• 19.4 GAS DETECTION EQUIPMENT?

  Yes

  No

  N/A

• 19.5 SAFETY/RESCUE EQUIPMENT

  Yes

  No

  N/A

PLANT & MACHINERY.

• 20.1 APPROPRIATE FOR USE?

  Yes

  No

  N/A

• 20.2 CONDITION?

  Yes

  No

  N/A

• 20.3 MAINTENANCE/CERTIFICATES?

  Yes

  No

  N/A

• 20.4 OPERATORS TRAINED

  Yes

  No

  N/A

21.0 INSPECTIONS

• 21.1 BOILERS/PRESSURE

  Yes

  No

  N/A

• 21.2 SCAFFOLD?

  Yes

  No

  N/A

• 21.3 EXCAVATIONS?

  Yes

  No

  N/A

• 22.0 LIFTING EQUIPMENT

  Yes

  No

  N/A

22 ENVIRONMENT

• 22.1 WASTE MINIMISATION

  Yes

  No

  N/A

• 22.2 WASTE STORAGE/DISPOSAL

  Yes

  No

  N/A

• 22.3 POLLUTION CONTROL

  Yes

  No

  N/A

• 22.4 DISCHARGES

  Yes

  No

  N/A

23.0 TRANSPORT & STORAGE

• 23.1 MATERIALS?

  Yes

  No

  N/A

• 23.2 CORRECTLY STORED?

  Yes

  No

  N/A

• 23.3 CORRECTLY TRANSPORTED

  Yes

  No

  N/A

• VEHICLE MOVEMENT?

  Yes

  No

  N/A

24.0 LIFTING OPERATIONS

• 24.1 COMPETENT OPERATION?

  Yes

  No

  N/A

• 24.2 SLINGER & LIFT CO-ORDINATOR

  Yes

  No

  N/A

• 24.3 SITE & GROUND CONDITIONS

  Yes

  No

  N/A

• 24.4 WORKING LOADS KNOWN?

  Yes

  No

  N/A

• 24.5 PRE-LIFT/LIFT CHECKLISTS

  Yes

  No

  N/A

25.0 SCAFFOLDING/ALUMINIUM TOWER

• 25.1 COMPETENT PERSONS?

  Yes

  No

  N/A

• 25.2 HANDOVER CERTIFICATE?

  Yes

  No

  N/A

• 25.3 INSPECTION REGISTER TO DATE?

  Yes

  No

  N/A

• 25.4 GROUND INSPECTIONS

  Yes

  No

  N/A

• 25.5 GUARD RAILS, ACCESS?

  Yes

  No

  N/A

• 25.6 LADDERS, BRACING, TIES?

  Yes

  No

  N/A

• 25.7 SECURITY OF SCAFFOLD?

  Yes

  No

  N/A

• 25.8 CONDITION OF TOWER?

  Safe

  At Risk

  N/A

• Yes

  No

  N/A

• ASSESSMENT SITE OPERATIONS

  Select GOOD FAIR POOR UNSATISFACTORY

  • GOOD
  • FAIR
  • POOR
  • UNSATISFACTORY

• ASSESSMENT MANAGEMENT SYSTEMS

  Select GOOD FAIR POOR UNSATISFACTORY

  • GOOD
  • FAIR
  • POOR
  • UNSATISFACTORY

• CONFIRMATION FROM AUDITEE THAT HAVE RECEIVED THE INFORMATION & RECOMMENDATIONS IN THE REPORT.

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• CONFIRMATION THAT THE AUDITOR HAS DISCUSSED ALL MATTERS ARISING WITH THE AUDITEE

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• DISTRIBUTION: PROJECT MANAGER/TEAM H & S/IMS ADVISORS- A.SMALLWOODS ,S.NICHOLSON H & S DIRECTOR- BRENDA REGAN