Information

  • LCL Number

  • Job / Project Number

  • Client Job/Project Title

  • Location
  • Conducted on

  • Team Names

Front of Vehicle

  • Is Vehicle; Secure / ignition keys removed / parked safely?

  • Is the front of the vehicle clean and tidy?

  • Suitable work pack on site containing work instruction, construction drawing and utility drawings

  • Utility Plans legible & current?

  • Are NRSWA permit conditions on site?

  • Is the Site specific risk Assessment for the location sufficient and all team members aware of requirements?

  • Are all Training Certificates for the team available and appropriate.

  • Do all team members have DNO identification?

  • Is COSHH information on site?

Rear of Vehicle

  • Is the rear of the van clean and tidy?

  • Take Photograph

  • Is Fire Extinguisher suitable and in date? Record date.

  • Date:

  • Is first aid kit available and in date? Record date.

  • Date:

  • Is eye wash in date and available? Record date.

  • Date:

  • Is fuel stored and labelled?

  • Take photograph

  • Is PPE being correctly stored?

  • Is water in appropriate container and labelled?

  • Take Photograph

  • Is a suitable spill kit available?

  • Is CAT in good working order and calibrated? Please record date.

  • Date:

  • Is Genny in good working order and calibrated? Please record date.

  • Date:

Trailer

  • Is trailer gate up and secure?

  • Is trailer in good order and are the lights functioning

  • Is number plate correct and appropriate?

  • Is there a break away cable and is it in good condition?

  • Are there 3 straps and are these in good condition?

  • Take Photograph of Trailer

  • Take Photograph of Trailer

Work Area

  • Is signing and guarding correct? (NRSWA)

  • Take photograph

  • Are plant, equipment, materials and vehicles arranged safely?

  • Take photograph

  • Are operatives working safely - and wearing PPE?

  • Is the general housekeeping of the site satisfactory?

  • Are appropriate information and courtesy signs posted?

  • Take photograph

  • Is there Safe Access/Egress for site staff?

  • Is there Safe Access/Egress for the public?

  • Are walk boards fit for purpose?

  • Are walk boards secured?

  • Take photograph showing securing pins.

  • Is Spoil away from the edge of the excavation?

  • Take Photograph:

  • Is the spoil contained with in the Barriers?

  • Take Photograph

  • Is the trench excavated to the correct depth?

  • Take photograph of measure 1

  • Take photograph of measure 3

  • Take photograph of measure 2

  • Are exposed cables tile tapped?

  • Take Photograph

  • Are street lamps and street furniture safely excavated?

  • Are tree roots protected?

  • Are drains and water courses protected?

  • Are ducts laid to the correct depth?

  • Take Photograph

  • Is the excavator in good working order and fit for purpose?

  • Take Photograph of machine

Signature

  • Please sign.

  • Any Comments:

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.