Information
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LCL Number
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Job / Project Number
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Client Job/Project Title
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Location
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Conducted on
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Team Names
Front of Vehicle
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Is Vehicle; Secure / ignition keys removed / parked safely?
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Is the front of the vehicle clean and tidy?<br>
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Suitable work pack on site containing work instruction, construction drawing and utility drawings<br>
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Utility Plans legible & current?<br>
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Are NRSWA permit conditions on site?<br>
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Is the Site specific risk Assessment for the location sufficient and all team members aware of requirements?<br>
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Are all Training Certificates for the team available and appropriate. <br>
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Do all team members have DNO identification?<br>
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Is COSHH information on site?<br>
Rear of Vehicle
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Is the rear of the van clean and tidy?<br>
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Take Photograph
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Is Fire Extinguisher suitable and in date? Record date.<br>
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Date:
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Is first aid kit available and in date? Record date.<br>
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Date:
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Is eye wash in date and available? Record date.<br>
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Date:
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Is eye wash in date and available? Record date.<br>
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Date:
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Is fuel stored and labelled?<br>
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Take photograph
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Is PPE being correctly stored?<br>
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Is water in appropriate container and labelled?<br>
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Take Photograph
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Is a suitable spill kit available?<br>
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Is CAT in good working order and calibrated? Please record date.<br>
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Date:
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Is Genny in good working order and calibrated? Please record date.<br>
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Date:
Trailer
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Is trailer gate up and secure?<br>
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Is trailer in good order and are the lights functioning<br>
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Is number plate correct and appropriate?
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Is there a break away cable and is it in good condition?
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Are there 3 straps and are these in good condition?<br>
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Take Photograph of Trailer
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Take Photograph of Trailer
Work Area
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Is signing and guarding correct? (NRSWA)
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Take photograph
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Are plant, equipment, materials and vehicles arranged safely?<br>
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Take photograph
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Are operatives working safely - and wearing PPE?<br>
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Is the general housekeeping of the site satisfactory?
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Are appropriate information and courtesy signs posted?<br>
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Take photograph
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Is there Safe Access/Egress for site staff?<br>
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Is there Safe Access/Egress for the public?<br>
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Are walk boards fit for purpose?<br>
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Are walk boards secured?
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Take photograph showing securing pins.
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Is Spoil away from the edge of the excavation?<br><br>
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Take Photograph:
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Is spoil protruding under the barriers?
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Take Photograph
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What is the average depth of the trench?
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Take photograph of measure 1
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Take photograph of measure 3
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Take photograph of measure 2
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Are exposed cables tile tapped?<br>
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Take Photograph
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Are tree roots protected?<br>
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Are street lamps and street furniture safely excavated?<br>
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Are drains and water courses protected?<br>
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What is the depth to the top of installed ducts?<br>
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Take Photograph
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Is excavator in good working order and fit for purpose?<br>
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Take Photograph of machine
Signature
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Please sign.
