GIG Method Statement & Risk Assessment Check List

• Client

• Site/Contract

• Location
  Address

• Carried out by: M FIX

• Manager

• Conducted on

  Date

Method Statement

• Method Statement detail the Organisations Name/Address?

  Yes

  No

  N/A

• Method Statement detail Title, date, issue & where applicable, revision number?

  Yes

  No

  N/A

• Method Statement detail what is to be done? (Scope of works)

  Yes

  No

  N/A

• Method Statement detail the location of works?

  Yes

  No

  N/A

• Method Statement detail the sequence of works?

  Yes

  No

  N/A

• Method Statement detail the Commencement Date?

  Yes

  No

  N/A

• Method Statement detail the duration of Works?

  Yes

  No

  N/A

• Does the Method Statement detail if Permits to Work are required/issuing party?

  Yes

  No

  N/A

Resources Required

• Does the Method Statement detail personnel involved in compiling documentation?

  Yes

  No

  N/A

• Does the Method Statement detail Supervision arrangements?

  Yes

  No

  N/A

• Does the Method Statement detail personnel & competency involved in operations?

  Yes

  No

  N/A

• Does the Method Statement detail plant & equipment to be used?

  Yes

  No

  N/A

• Does the Method Statement detail materials to be used?

  Yes

  No

  N/A

Risk Assessment Checklist

• Access / Egress

  Yes

  No

  N/A

• Place of work (confined space / work at height etc)

  Yes

  No

  N/A

• Person(s) at Risk (Employees/Visitors/Public/Others etc)

  Yes

  No

  N/A

• Physical (Noise, Vibration, Manual Handling)

  Yes

  No

  N/A

• COSHH Assessment

  Yes

  No

  N/A

• Environmental issues (vegetation/watercourse/waste/wildlife etc)

  Yes

  No

  N/A

Control Measures

• Permits (Dig/Hot Work/Confined Space etc)

  Yes

  No

  N/A

• Fencing/Barriers/Signage

  Yes

  No

  N/A

• Competency/Specialist Training (Plant/Confined Space/NRASWA/First Aid etc)

  Yes

  No

  N/A

Personal Protective Equipment

• List of PPE required for tasks undertaken

  Yes

  No

  N/A

Emergency Arrangements

• Qualified First Aiders named & contact details / location detailed

  Yes

  No

  N/A

• Special First Aid Requirements

  Yes

  No

  N/A

• Environmental Emergency Actions (eg Fire)

  Yes

  No

  N/A

• Rescue plan (where applicable eg Confined Space)

  Yes

  No

  N/A

Planning

• Traffic and pedestrian routes

  Yes

  No

  N/A

• Fire Escape Routes

  Yes

  No

  N/A

• Services (detailed/communicated/records held)

  Yes

  No

  N/A

Provision & Communication of Information

• Does the document need approval by 'other Party' prior to works proceeding?

  Yes

  No

  N/A

• Has the document been reviewed and approved prior to works commencing?

  Yes

  No

  N/A

• Have all personnel involved in the works been briefed of its content and signatures obtained?

  Yes

  No

  N/A

Monitoring & Compliance

• Does the document detail who will monitor the works and how?

  Yes

  No

  N/A

Comments

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• On Site Representative/Supervisor

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• Carried out by

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