Information

  • LCL Number

  • Job / Project Number

  • Client Job/Project Title

  • Location
  • Conducted on

  • Team Names

Vehicle and Winch

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

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

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

  • Do all team members have DNO identification?<br>

  • Is the winch positioned correctly and fenced off?

  • Does the winch operator know the correct pulling tension for the cable being installed?

  • Are cable pulling tensions available on site?

  • is the winch in calibration?

  • Is the cable pulling stocking attached correctly?

  • Is pulling eye attached?

  • Take photograph

Cable Trench

  • Is there safe access and egress for the public?

  • Is there safe access and egress for site staff?

  • Is the cable trench sanded?

  • Take Photograph of trench?

  • Take Photograph of trench?

  • Is the cable trench excavated to the correct depth?

  • Is the trench free of debris and stones?

  • Are cable rollers being used?

  • Are cable rollers spaced correctly?

  • Take photograph

  • Take photograph

  • Take photograph

  • Are bell mouths being used and installed correctly?

  • Take photograph.

  • is there communication between the winch operator and other members of staff?

  • Is the general house keeping on site satisfactory?

Signature

  • Please sign.

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.