Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

1. Scope of Works to be inspected/ Surveyed

  • Add media

2. Design

  • 2.1 Is a Detailed Design Available where applicable?

  • Add media

3. Buried Services

  • 3.1 Is there evidence that buried service information is kept onsite?

  • 3.2 Have buried services been identified and marked out?

  • 3.3 Is there a permit to dig form in-place and evidence of use?

  • Evidence of permit to dig and marking out of service

  • Evidence of Permit to Dig / Buried Service
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  • 3.4 Is the CAT Scan NWR approved and calibrated?

  • Evidence of CAT and Genny approved and Calibrated

  • CAT and Genny
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4. Housekeeping

  • 4.1 Has all line-side waste been removed where applicable?

  • 4.2 Have all onsite material and equipment (cable drums / troughing etc) been stored adequately?

  • 4.3 Are vans clean and tidy?

  • 4.4 Have vans been park to prevent blocking access to other users?

  • 4.5 Is there evidence that previous worked in REB(s) have been cleared by Linbrooke teams?

  • Housekeeping Compliance Evidence

  • Housekeeping
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5. Security

  • 5.1 If plant / vehicles are on-site have all keys been removed to remove temptation of theft?

  • 5.2 Have all tools been stored away safely that are not in use to prevent theft?

  • 5.3 Are all security systems in-place checked for suitability and maintained (where applicable)? Are the teams aware what to do in the event of a member of the public onsite? Are mobile phones and valuables hidden from sight?

  • 5.4 Have the site reported any issues with members of the public and or trespassers?

  • 5.5 Is the site secure when teams are not on-site?

  • Evidence of security compliance

  • Security
  • Add media

6. Welfare

  • 6.1 Are there welfare facilities on-site, if yes are the facilities compliant with the project welfare assessment and Network Rail Standard for the number of personnel working?

  • 6.2 Are the facilities clean, tidy and emptied on a regular basis?

  • 6.3 If the work is identified as transient do the team have access to facilities and is this documented?

  • Evidence of Welfare Compliance

  • Welfare
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7. Are there any other notable issues to be recorded?

    Issues or Good practice
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8. Positive feedback

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9. Observations

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10. Non-conformances raised

  • Add media

11. Team Competencies

  • Does all the Team have there Sentinel cards available for inspection?

  • Add media

  • Do the team have the appropriate competencies for the tools/ plant being used on site?

  • Add media

12. Feedback from team?

  • Have the team had a de-briefing on findings?

  • Has the supervisor had a de-briefing on issues and any immediate actions to be undertaken?

  • Auditor Signature

  • Site Supervisor / Manager 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.