Title Page
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Branch / Contract:
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Conducted On:
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Prepared By:
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Location:
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Job Ref:
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Gang Name:
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Gang Lead Name:
Documentation
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Are statutory Local Authority Notices, available and in date?
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Have adequate Risk Assessments and Method Statements been produced and communicated to all operatives involved in the work?
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Have all operatives undertaken the 'Glenevin Onboarding Training'?
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Have all operatives been adequately trained for the work they are undertaking, with their training records available for inspection?
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Are Accident, Incident, Near Miss & Emergency Procedures in place?
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Have the Gang logged into their work platform? i.e. Depotnet, AFS etc. & viewed the relevant drawings, taken pictures of the site etc.
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Have existing damage surveys been carried out on nearby cars and property to the works?
Vehicle Checks
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Is the vehicle clean and tidy?
- Fully
- Mostly
- Partly
- Some
- Not At All
- N/A
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Has the driver completed a recorded pre-use inspection on CheckedSafe App?
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Do they know how to use the application?
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Have they got a serviceable fire extinguisher, first aid kit and eye wash on the vehicle.
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Does the vehicle have a trailer?
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Is there a number plate for the trailer matching the vehicle?
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Is there a good condition breakaway cable on the trailer and is it being used?
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If there is an Excavator on the trailer are there 3 good condition straps used to secure it?
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Does the van have suitable warning devices and signage? ( i.e. Flashing Amber Beacons, Rear Chevrons, Highway Maintenance, COSHH Symbols etc.)
- Fully
- Mostly
- Partly
- Some
- Not At All
- N/A
Safety Provisions
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Are welfare facilities available within a 10-minute commute from the working area?
Site Setup
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Are advance warning signs (Men at Work) in place on all approaches?
- No Issues
- Issues Rectified During Inspection
- Issues Present
- N/A
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Are 'Road Narrow's' signs in place and correctly positioned for the work taking place?
- No Issues
- Issues Rectified During Inspection
- Issues Present
- N/A
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Are 'Footpath Closed' & 'Footpath Closed Ahead' signs in place and correctly positioned?
- No Issues
- Issues Rectified During Inspection
- Issues Present
- N/A
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Are all barriers in good condition, of the same spec and are they all clipped together?
- No Issues
- Issues Rectified During Inspection
- Issues Present
- N/A
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Have barriers been used to prevent residents from gaining access to the site from their properties?
- No Issues
- Issues Rectified During Inspection
- Issues Present
- N/A
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Are there sufficient courtesy boards displayed?
- No Issues
- Issues Rectified During Inspection
- Issues Present
- N/A
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Are there sufficient sandbags on all barriers and signage?
- No Issues
- Issues Rectified During Inspection
- Issues Present
- N/A
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Are Traffic Cones used sufficiently on the site?
- No Issues
- Issues Rectified During Inspection
- Issues Present
- N/A
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Are Blue Arrow Signs in place and positioned correctly?
- No Issues
- Issues Rectified During Inspection
- Issues Present
- N/A
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If the work involves a road crossing, have plates or boards been secured in position to make the area safe?
- No Issues
- Issues Rectified During Inspection
- Issues Present
- N/A
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If Traffic Management is in place, is it fit for purpose?
- No Issues
- Issues Rectified During Inspection
- Issues Present
- N/A
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Does the working site have safe Access/Egress for Operatives?
- No Issues
- Issues Rectified During Inspection
- Issues Present
- N/A
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Are all materials stored neatly, securely and segregated from the public?
- No Issues
- Issues Rectified During Inspection
- Issues Present
- N/A
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Are housekeeping standards on site acceptable?
- No Issues
- Issues Rectified During Inspection
- Issues Present
- N/A
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Have suitable access points been setup for any residents affected by the works?
- No Issues
- Issues Rectified During Inspection
- Issues Present
- N/A
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Are pedestrian walkways at least 1.2m wide and clear of obstructions or trip hazards?
- No Issues
- Issues Rectified During Inspection
- Issues Present
- N/A
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Have sufficient ramps/walk boards been deployed?
- No Issues
- Issues Rectified During Inspection
- Issues Present
- N/A
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Is there any immediate risk to public safety? (Has the site been set up as per chapter 8)
- No Issues
- Issues Rectified During Inspection
- Issues Present
- N/A
Excavations
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Have located existing services been marked up?
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Have suitable trial holes been excavated?
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Has the Cat & Genny been used correctly, before/during excavation works? (Download Data)
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Is there evidence of safe digging practices being followed?
PPE
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Are all operatives wearing the correct PPE with the correct branding?
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Is all PPE suitable and serviceable?
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Is sufficient PPE available on-site including provisions to protect against hazardous substances?
Work Equipment
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Are tools and equipment stored correctly?
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Are power tools and hand tools serviceable and fit for use including, switches, cords and guards?
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Has all Plant & Machinery been checked prior to use, serviceable, calibrated and fit for use?
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Has a HAVS assessment been carried out for all relevant equipment?
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Do all equipment users hold the relevant qualification/license/ticket for the equipment in use?
Operatives
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Are all operatives conducting themself in a professional and safe manner in accordance with company guidelines?
Environmental
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Have adequate controls or precautions been implemented to prevent spills and are there suitable spillage kits available should a spill occur?
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Are operatives familiar with the procedure to be followed in the event of a harmful environmental situation on site?
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Have all excavation works taken place as per the NJUG Tree Protection Zone?
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Has a noise assessment been completed?
COSHH
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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)
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Are all COSHH items securely stored in correct containers with labels clearly displayed?
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Have COSHH Assessments been carried out on all hazardous substances?
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Is there any evidence of spills on site?
Sign Off
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HSE Sign Off:
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Supervisors Sign Off: