Title Page

  • Branch / Contract:

  • Conducted On:

  • Prepared By:

  • Location:
  • Job Ref:

  • Gang Name:

  • Gang Lead Name:

Documentation

  • Are statutory Local Authority Notices, available and in date?

  • Have adequate Risk Assessments and Method Statements been produced and communicated to all operatives involved in the work?

  • Have all operatives undertaken the 'Glenevin Onboarding Training'?

  • Have all operatives been adequately trained for the work they are undertaking, with their training records available for inspection?

  • Are Accident, Incident, Near Miss & Emergency Procedures in place?

  • Have the Gang logged into their work platform? i.e. Depotnet, AFS etc. & viewed the relevant drawings, taken pictures of the site etc.

  • Have existing damage surveys been carried out on nearby cars and property to the works?

Vehicle Checks

  • Is the vehicle clean and tidy?

  • Has the driver completed a recorded pre-use inspection on CheckedSafe App?

  • Do they know how to use the application?

  • Have they got a serviceable fire extinguisher, first aid kit and eye wash on the vehicle.

  • Does the vehicle have a trailer?

  • Is there a number plate for the trailer matching the vehicle?

  • Is there a good condition breakaway cable on the trailer and is it being used?

  • If there is an Excavator on the trailer are there 3 good condition straps used to secure it?

  • Does the van have suitable warning devices and signage? ( i.e. Flashing Amber Beacons, Rear Chevrons, Highway Maintenance, COSHH Symbols etc.)

Safety Provisions

  • Are welfare facilities available within a 10-minute commute from the working area?

Site Setup

  • Are advance warning signs (Men at Work) in place on all approaches?

  • Are 'Road Narrow's' signs in place and correctly positioned for the work taking place?

  • Are 'Footpath Closed' & 'Footpath Closed Ahead' signs in place and correctly positioned?

  • Are all barriers in good condition, of the same spec and are they all clipped together?

  • Have barriers been used to prevent residents from gaining access to the site from their properties?

  • Are there sufficient courtesy boards displayed?

  • Are there sufficient sandbags on all barriers and signage?

  • Are Traffic Cones used sufficiently on the site?

  • Are Blue Arrow Signs in place and positioned correctly?

  • If the work involves a road crossing, have plates or boards been secured in position to make the area safe?

  • If Traffic Management is in place, is it fit for purpose?

  • Does the working site have safe Access/Egress for Operatives?

  • Are all materials stored neatly, securely and segregated from the public?

  • Are housekeeping standards on site acceptable?

  • Have suitable access points been setup for any residents affected by the works?

  • Are pedestrian walkways at least 1.2m wide and clear of obstructions or trip hazards?

  • Have sufficient ramps/walk boards been deployed?

  • Is there any immediate risk to public safety? (Has the site been set up as per chapter 8)

Excavations

  • Have located existing services been marked up?

  • Have suitable trial holes been excavated?

  • Has the Cat & Genny been used correctly, before/during excavation works? (Download Data)

  • Is there evidence of safe digging practices being followed?

PPE

  • Are all operatives wearing the correct PPE with the correct branding?

  • Is all PPE suitable and serviceable?

  • Is sufficient PPE available on-site including provisions to protect against hazardous substances?

Work Equipment

  • Are tools and equipment stored correctly?

  • Are power tools and hand tools serviceable and fit for use including, switches, cords and guards?

  • Has all Plant & Machinery been checked prior to use, serviceable, calibrated and fit for use?

  • Has a HAVS assessment been carried out for all relevant equipment?

  • Do all equipment users hold the relevant qualification/license/ticket for the equipment in use?

Operatives

  • Are all operatives conducting themself in a professional and safe manner in accordance with company guidelines?

Environmental

  • Have adequate controls or precautions been implemented to prevent spills and are there suitable spillage kits available should a spill occur?

  • Are operatives familiar with the procedure to be followed in the event of a harmful environmental situation on site?

  • Have all excavation works taken place as per the NJUG Tree Protection Zone?

  • Has a noise assessment been completed?

COSHH

  • Is all fuelled plant and equipment stored in a manner that prevents any chemical spillage? (e.g. Stihl saws / jerry cans, stored on drip trays or plant nappies)

  • Are all COSHH items securely stored in correct containers with labels clearly displayed?

  • Have COSHH Assessments been carried out on all hazardous substances?

  • Is there any evidence of spills on site?

Sign Off

  • HSE Sign Off:

  • Supervisors Sign Off:

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.