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?
- YES
- NO
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Is the front of the vehicle clean and tidy?
- YES
- NO
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Suitable work pack on site containing work instruction, construction drawing and utility drawings
- YES
- NO
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Utility Plans legible & current?
- YES
- NO
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Are NRSWA permit conditions on site?
- YES
- NO
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Is the Site specific risk Assessment for the location sufficient and all team members aware of requirements?
- YES
- NO
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Are all Training Certificates for the team available and appropriate.
- YES
- NO
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Do all team members have DNO identification?
- YES
- NO
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Is COSHH information on site?
- YES
- NO
Rear of Vehicle
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Is the rear of the van clean and tidy?
- YES
- NO
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Take Photograph
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Is Fire Extinguisher suitable and in date? Record date.
- YES
- NO
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Date:
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Is first aid kit available and in date? Record date.
- YES
- NO
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Date:
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Is eye wash in date and available? Record date.
- YES
- NO
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Date:
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Is fuel stored and labelled?
- YES
- NO
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Take photograph
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Is PPE being correctly stored?
- YES
- NO
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Is water in appropriate container and labelled?
- YES
- NO
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Take Photograph
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Is a suitable spill kit available?
- YES
- NO
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Is CAT in good working order and calibrated? Please record date.
- YES
- NO
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Date:
-
Is Genny in good working order and calibrated? Please record date.
- YES
- NO
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Date:
Trailer
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Is trailer gate up and secure?
- YES
- NO
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Is trailer in good order and are the lights functioning
- YES
- NO
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Is number plate correct and appropriate?
- YES
- NO
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Is there a break away cable and is it in good condition?
- YES
- NO
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Are there 3 straps and are these in good condition?
- YES
- NO
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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)
- YES
- NO
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Take photograph
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Are plant, equipment, materials and vehicles arranged safely?
- YES
- NO
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Take photograph
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Are operatives working safely - and wearing PPE?
- YES
- NO
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Is the general housekeeping of the site satisfactory?
- YES
- NO
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Are appropriate information and courtesy signs posted?
- YES
- NO
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Take photograph
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Is there Safe Access/Egress for site staff?
- YES
- NO
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Is there Safe Access/Egress for the public?
- YES
- NO
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Are walk boards fit for purpose?
- YES
- NO
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Are walk boards secured?
- YES
- NO
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Take photograph showing securing pins.
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Is Spoil away from the edge of the excavation?
- YES
- NO
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Take Photograph:
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Is the spoil contained with in the Barriers?
- YES
- NO
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Take Photograph
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Is the trench excavated to the correct depth?
- YES
- NO
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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?
- YES
- NO
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Take Photograph
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Are street lamps and street furniture safely excavated?
- YES
- NO
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Are tree roots protected?
- YES
- NO
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Are drains and water courses protected?
- YES
- NO
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Are ducts laid to the correct depth?
- YES
- NO
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Take Photograph
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Is the excavator in good working order and fit for purpose?
- YES
- NO
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Take Photograph of machine
Signature
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Please sign.
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Any Comments:
