Depot works On-Site V2

• CPA works order number

• Site name

• Conducted on

  Date

• Supervisor

• Location
  Address

• Gang Name

• Site photo

  Media

Safety Observations

• Housekeeping (free of hazards)?

  Safe

  At Risk

  N/A

• Service avoidance (under and overhead) use of CAT

  Safe

  At Risk

  N/A

• PPE

  Safe

  At Risk

  N/A

• Noise/dust

  Safe

  At Risk

  N/A

• Manual Handling(reduced where possible)

  Safe

  At Risk

  N/A

• Fire protection and First Aid

  Safe

  At Risk

  N/A

• Ladders/cherry picker

  Safe

  At Risk

  N/A

• Cutting & Grinding

  Safe

  At Risk

  N/A

• Is COSHH being used correctly?(labelled containers etc)

  Safe

  At Risk

  N/A

• Are fuel containers labelled with correct UN codes?

  Yes

  No

  N/A

• Lifting Equipment (in date test etc)

  Yes

  No

  N/A

• HAV's

  Safe

  At Risk

  N/A

Traffic management

• Are all signs and cones laid in accordance with CH8?

  Yes

  No

  N/A

• Is there a safe route for pedestrians?

  Yes

  No

  N/A

Quality

• Are works following design? Record CVI if necessary.

  Yes

  No

  N/A

• Are the gang making expected progress?

  Yes

  No

  N/A

• Are the materials correct to the job?

  Yes

  No

  N/A

• Are Plant & vehicle correct to the job?

  Yes

  No

  N/A

• Are the operatives correct for this work?

  Yes

  No

  N/A

• Does the Site layout look correct?

  Yes

  No

  N/A

Drainage

• Drainage

  Off

  On

• Is correct ironwork class in use? i.e. D400

  Yes

  No

  N/A

• Is line and level of pipe work correct to the design?

  Yes

  No

  N/A

• Are manholes and gullies constructed correctly?

  Yes

  No

  N/A

• Does bed and surround meet specification?

  Yes

  No

  N/A

• Are pipe joints closed?

  Yes

  No

  N/A

Earthworks

• Earthworks

  Off

  On

• Is line and level correct ?

  Yes

  No

  N/A

• Edge Shoring: Have the tie wires been correctly installed ?

  Yes

  No

  N/A

• Edge Shoring: have the correct posts been used and are they driven to correct depth?

  Yes

  No

  N/A

• Gabion: Has the correct fill been used? i.e. Class 6G

  Yes

  No

  N/A

• Gabions: Has the correct basket been used i.e. Welded mesh baskets?

  Yes

  No

  N/A

Footways

• Footways

  Off

  On

• Has all ironwork been adjusted to correct level?

  Yes

  No

  N/A

• Does the footway have a fall to allow free drainage i.e. no ponding?

  Yes

  No

  N/A

• Are asphalt layers the correct the correct thickness and compacted properly?

  Yes

  No

  N/A

• Is sub-base material properly compacted?

  Yes

  No

  N/A

• Has weed treatment been applied to sub grade?

  Yes

  No

  N/A

• Has existing footway been excavated to correct depth?

  Yes

  No

  N/A

• Are kerbs laid to correct line and level?

  Yes

  No

  N/A

• Have kerb lines been excavated to correct depth?

  Yes

  No

  N/A

Patching

• Patching

  Off

  On

• Are patches planed to correct depth?

  Yes

  No

  N/A

• Has bond coat been applied to both base AND vertical edges?

  Yes

  No

  N/A

• Has the material temp been checked before laying?

  Yes

  No

  N/A

• Are patches compacted satisfactorily?

  Yes

  No

  N/A

Grass/Hedge cutting

• Grass/Hedge cutting

  Off

  On

• Is the grass cut to 75mm +/- 25mm?

  Yes

  No

  N/A

• Are number of swathes cut correct?

  Yes

  No

  N/A

• Is strimming carried out around street furniture ?

  Yes

  No

  N/A

• Have all visibility splays been cut correctly?

  Yes

  No

  N/A

• Confirm sensitive sites have not been cut?

  Yes

  No

  N/A

Jetting/gullying

• Jetting/Gully Emptying

  Off

  On

• Is there evidence gully pots have been properly cleaned?

  Yes

  No

  N/A

• Have tops been cleaned and surround cut back 100mm?

  Yes

  No

  N/A

Roadmarkings

• Roadmarkings

  Off

  On

• Is line of the required quality?

  Yes

  No

  N/A

• Are the lines in the correct position?

  Yes

  No

  N/A

• Are the line spacings and line widths correct?

  Yes

  No

  N/A

• Yes

  No

  N/A

Sign maintenance

• Sign maintenance

  Off

  On

• Has the correct post foundation used ? i.e. size and depth

  Yes

  No

  N/A

• Does the sign have a manufacturers label?

  Yes

  No

  N/A

• Has the correct post size been used and is the sign face installed at the correct height ?

  Yes

  No

  N/A

• Working at height (safe ladder use, tools on lanyards, MEWP certificate etc)

  Safe

  At Risk

  N/A

• For multi-panel signs, have butting clamps been fitted?

  Yes

  No

  N/A

Safety Defects

• Safety Defects

  Off

  On

• Have defects been saw cut with vertical edges?

  Yes

  No

  N/A

• Has bond coat been applied to both edges AND base?

  Yes

  No

  N/A

• Is asphalt hot and compacted?

  Yes

  No

  N/A

Driver Checks

• Drivers licence checked?

  Yes

  No

  N/A

• CPC card present and checked?

  Yes

  No

  N/A

• Defect book checked?

  Yes

  No

  N/A

• Driver log book checked?

  Yes

  No

  N/A

Acknowledgement

• Chargehand signature

  Sign

• Supervisor Signature

  Sign