Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

General Information

  • Contractors Name completing the survey;

  • Addition sub contractors assisting with survey? (Detail company name in notes section)

Surveyor Name;

  • Daniel Albert

  • Mike Kavanagh

  • David Ferris

Building Type;

  • Domestic

  • Commercial

  • Industrial

Brief Description of Works;

  • Description of works

  • Type of survey

Audit Type

  • Audit type

Project Details

  • Has the surveyor been given accurate information and equipment to complete survey?

  • Has the surveyor liased with site contact?

  • Has a site walkthrough been undertaken with site contact?

  • Have keys been issued to the surveyor for access?

  • Does surveyor know where nearest A&E is located in an emergency?

Welfare

  • Are welfare arrangements in place for surveyor(s)

Health & Safety

  • Does the surveyor have all necessary health and safety equipment available e.g gloves, safety boots, hi viz vest / coat, type 5/6 overalls, safety glasses etc? (Detail missing equipment in notes section)

  • Has a site specific induction been undertaken prior to starting survey?

  • Does the surveyor have a valid face fit for mask type worn?

  • What mask is worn by surveyor for sampling? (Detail model type in notes section)

  • Is surveyor clean shaven?

  • Is mask tagged and uniquely identifiable to surveyor wearing it?

  • Is the surveyor lone working? (Please detail second man in notes section)

Vehicle

  • Spare tyre?

  • First aid kit?

  • Fire extinguisher?

  • Mirrors?

  • Windscreen wipers and windscreen fluid?

  • Tyres legal? (Include spare)

  • Lights working?

  • Oil levels ok?

  • Brake fluid levels ok?

  • Windscreen condition satisfactory?

  • Vehicle damage defects identified by auditor (not reported)?

Surveyor Training & Competencies

  • Training currently held

Risk Assessment & Control Measures

  • Has the surveyor completed an on-site dynamic risk assessment before starting survey?

  • Are control measures adopted suitable?

  • Is the surveyor aware of Fusion emergency procedures in the event of an accident on site?

ACM’s Identified;

  • Have ACM’s been identified by the surveyor?

  • Any additional ACM's Identified during audit? (not picked up by surveyor)

  • Is sample data collection accurate?

  • Is material assessment scoring correct?

  • Is Priority assessment scoring correct?

  • Are sample bags uniquely identifiable as per company procedures?

  • Plans/Rooms uniquely identifiable as per company procedures?

Drawings / Plans

  • Hand drawn sketch plans used?

  • Digital Xodo app used?

  • Are samples accurately marked on plans?

  • Are rooms uniquely identifiable on plans?

  • Is project number, building address, date and pagination on plan(S)

Sampling Strategy

  • Was the correct sampling strategy adopted for the material type?

  • Was ACM sufficiently dampened with water & surfactant mixture?

  • Is sample of sufficient size as per HSG264 & Fusion surveying procedures?

  • Has the sample location been adequately sealed and/or labelled?

  • Was all PPE & RPE worn correctly?

  • We’re sampling tools cleaned after use to avoid any possible cross contamination?

  • Was all waste disposed of correctly?

No Access Areas

  • Have all areas been accessed as per scope of works? If not have plans been demarcated and data recorded correctly?

  • Has the client been notified of non accessible locations before leaving site?

Limitations

  • Are there any limited accesses?

  • Have the limitations been recorded as per scope of works?

Assessment Sumary

  • Audit outcome

  • Auditor signature

  • Date & time

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