Title Page
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Permit Number
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Site conducted
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Conducted on
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Prepared by
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Location
Live Site
SITE DOCUMENTATION
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SSRA/RAMS
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PIA/NRSWA Qualified Persons Onsite
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Permit Conditions Being Met
- Yes
- No
- N/A
SLG
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TM & Pedestrian Provision Match Permit
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Signage & Barriers free from damage
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Signage & Barriers correctly placed and connected as per Red book
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1.2m clearance For PEDS being Maintained
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Is The Work Area Clean & Tidy
Excavation, Backfill , Reinstatement
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Cat & Genny Calibrated
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Utility Stats onsite & Checked (Spray should be visible)
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Is Excavation to Correct Depth
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Muck & Spoil sited correctly within Site Barriers on footway Board
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Ducting, Subduct laid to Correct Depth
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Blockage Repair Kit Correctly Fitted
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Correct Base Layer, Compaction (CLegg Tested)
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Reinstatement Type Correct (150 rule Adhered too)
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Site Clean & Cleared
Health & Safety
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First Aid Kit In date
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PPE in Date Clean and fit for purpose
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Operatives Aware of Closest Welfare Facilities & Hospital
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Hand/power tools Free From Damage and in date
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Vehicle parked Safely
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Water Suppression in use
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Fuel/Oil/Lubricants Correctly Stored