Title Page
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JOB NUMBER
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CONDUCTED ON
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AUDITED BY
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LOCATION
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LEAD ENGINEER
GENERAL
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CIV01.01 - At least one operative on site conversant with<br>English language?
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CIV 01.02 - Is the site set up as per the agreed permit<br>conditions?
ROADWORKS GUARDING
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CIV02.01 - Contractors Information Board displayed on site?
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CIV02.02 - Correct size signs / barriers / cones for the speed of road and all plant and equipment placed within the barriers?
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CIV02.03 - Sandbags used when weighting is necessary?
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CIV02.04 - Are the safety zones and controls in place sufficient to prevent injury to operatives and members of the public from any activities being carried out?
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CIV02.05 - Lead in / exit taper in place with correct number of cones and angle of taper
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CIV02.06 - Minimum widths of carriageway maintained for<br>mode of traffic control employed?
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CIV02.07 - Pedestrian Walkway meets / exceeds minimum<br>width requirements
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CIV02.08 - Handrail and tapping rail in place, is the correct<br>height above the ground and meets the COP depth<br>requirements
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CIV02.09 - Kerb ramps/footway boards/road plates used when necessary
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CIV02.10 - Signs illuminated when required as per the Code of Practice?
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CIV02.11 - Where required, are suitable physical pedestrian<br>barriers in place around excavations ?
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CIV02.12 - Traffic control option meets criteria within the Code of Practice?
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CIV02.13 - Code of Practice “Safety at Street Works and Road Works” available on site?
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CIV02.14 - Are all vehicles positioned safely as per the Code of Practice
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CIV02.15 - Where COP cannot be applied, has an alternative<br>means of protecting pedestrians been recorded on the Site<br>Risk Assessment?
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CIV02.16 - Are vehicles and required plant fitted with fully<br>functional Amber Flashing Beacons?
SAFETY
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CIV03.01 - Do operatives have Electricity Prints as per HSG47 requirements
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CIV03.02 - Do operatives have Water prints on Site as per<br>HSG47 requirements
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CIV03.03 - Do operatives have Gas prints on Site as per HSG47 requirements
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CIV03.04 - Where excavation is required is there at least one<br>operative on site trained and able to demonstrate competent use the Cable Avoidance Equipment
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CIV03.05 - Evidence of tests for underground apparatus<br>location carried out on site correctly and marked out<br>accordingly?
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CIV03.06 - Health & Safety File available on site?
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CIV03.07 - Are Gas Bottles / Compressed Air Cylinders being<br>used / stored correctly?
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CIV03.08 - Are effective site communications in place?
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CIV03.09 - Where required is Personnel Protection Equipment on site as per confined spaces regulations (ie blowers / rescue equipment.)
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CIV03.10 - Confined Space compliance (Qualifications &<br>equipment). Where required are all persons sufficiently<br>trained in accordance with confined space arrangements
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CIV03.11 - Are mechanical lifters used when handling CW<br>covers where required
EXCAVATIONS
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CIV04.01 - Method / Machinery suitable for the Site / Job?
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CIV04.02 - Excavations in the vicinity of trees carried out in<br>line with correct specifications? (NJUG)
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CIV04.03 - Excavation shored to prevent loss of ground where required?
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CIV04.04 - Existing Ducts / Mains supported correctly?
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CIV04.05 - Excavated Material stored a safe distance away<br>from the excavation?
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CIV04.06 - Excavations carried out so as not to undermine<br>existing structures?
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CIV04.07 - Suitable safe access and egress provided?
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CIV04.08 - Trial (Pilot) holes undertaken onto expected or<br>anticipated services
PLANT & EQUIPMENT
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CIV05.01 - Is the Plant and Equipment (including safety<br>guards) in good condition and suitable for the work?
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CIV05.02 - Are All Portable Electric Tools And Equipment In<br>Good Condition And Have They Been PAT Tested?
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CIV05.03 - Are Operatives competent to operate the plant and equipment on site in line with their appointed role?
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CIV05.04 - Have the daily, weekly and monthly checks been<br>logged in the On site/Inspection Registe and has it been kept<br>up to date?
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CIV05.05 - Where trailers and towed plant are used, are they in good condition with an adequate means of securing the load during transport?
ENVIRONMENTAL
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CIV06.01 - Are Resins and other Compounds securely stored<br>and separated from inert material prior to disposal?
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CIV06.02 - Water from Chamber / Excavations disposed of<br>Properly?
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CIV06.03 - Is there a risk of contamination from the storage of concrete products/spoil/run off liquids entering adjacent<br>drains/gullies?
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CIV06.04 - Can operatives demostate that water samples have been taken and checked for comtamination
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CIV06.05 - Care taken to prevent Damage / Contamination to Paving / Tarmac / Grass etc from Fuel, Oil etc?
STOP WORK NOTICE
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CIV07.01 - Stop Work Notice issued for breach of Safety<br>Requirements?
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CIV07.02 - Stop Work Notice issued for breach of Contractual Requirements?
SITE AMD OTHER DOCUMENTATION
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CIV08.01 - Code of Practice “Specifications for Reinstatement of Openings in the Highway” available on site?
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CIV08.02 - Is Site Specific Daily Dynamic Risk Assessment<br>Available And Completed On Site?
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CIV08.03 - Is Safety Information Available On Site Applicable<br>To The Works Being Undertaken Including COSHH, RAMS etc..?
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CIV08.04 - Access to current issue of relevant Specification<br>available
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CIV08.05 - Work Pack containing all necessary Prints and<br>schematic Drawings available on site?
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CIV08.06 - Contractor has required NRSWA Notice?
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CIV08.07 - Site Personnel have correct NRSWA Accreditation / Registration for the work being executed where required?
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CIV08.08 - Operatives working in accordance with training,<br>accreditation and licensing rules
QUALITY
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CIV09.01 - Correct material laid around duct before backfill<br>(SAND/PEA SHINGLE)
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CIV09.02 - Is fresh Type 1 being used on site?
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CIV09.03 - Backfill/Subbase been stored or disposed of<br>correctly (To stop contamination) (Type 1)
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CIV09.04 - Was grey/black duct used?
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CIV09.05 - Was green fibre warning tape used
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CIV09.06 - Work site left tidy/Contrators rubbish removed?
SIGN OFF
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CIV10.01 - Does the overall audit constitute a risk to the<br>publics health and safety
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CIV10.02 - Has the overall audit passed or failed based on the<br>questions above
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Comments
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Lead Engineer Signature
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Auditor Signature
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Closure Date