H&S Audit Form - TRIAL

• Conducted on

  Date

• Prepared by

• Location
  Address

• LA Code

• Principal Contractor

• Main Works activity/s

  Select Site Clearence Lining Drainage kerbing Surfacing Arbs Electrical Excavation

  • Site Clearence
  • Lining
  • Drainage
  • kerbing
  • Surfacing
  • Arbs
  • Electrical
  • Excavation

Defenition of scoring

• Scoring: 1 - Below requirements - Major defects, 2 – below requirements -Minor defects 3 – Meets requirements

• Non applicable sections to excluded from review - Maximum 172 if all sections used

• Whole sections to be scored in full, DO NOT leave sections part filled

• 1 - Below requirements - Major defects - Major issues observed or controls not in place

• 2 - Below requirements - Minor defects - Minor adjustments to meet requirements

• 3 - Meets requirements - Meets company and legal requirements

Site Management

• Overall management of site

Site Establishment

• Is site organised?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Are signs and cones set out correctly?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Are signs and cones clean?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Are pedestrians/general public adequately catered for?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• If overhead cables are on site have they been identified and signed?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

Site Documentation

• Is correct documentation on site?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Are the site instructions clear and understood?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Is a permit board on site and being adhered to?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Is a plan and statutory information on site?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Is documentation completed correctly?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Is the work risk assessment compliant?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

Site management

• Are instructions being followed?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Are staff aware of there roles and obligations?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Are works being carried out in a safe manner?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Are the works safe and/or protected?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Are there any obstacles or obstructions on site?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

Welfare

• First aid box on site and sufficient?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Facilities for drinking/washing?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Toilet facilities - provision and cleanliness?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Eye wash facilities

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

PPE

• Hard hats and hi-vis in use and suitable?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Safety boots and suitable?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Ear/Eye protection and suitable?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Other PPE provided and suitable for task at hand?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

Communications

• Reviewed

  Y

  N

• Is the method of communication on site understood?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• What are arrangements for emergency assistance from off site?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

Competence

• Reviewed

  Y

  N

• Do we have the right skills on site?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Has correct training been provided?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

COSHH

• Reviewed

  Y

  N

• COSHH assessments available?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Containers labled?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Containers secured?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

Material and Plant Storage

• Reviewed

  Y

  N

• Materials safely stored/stacked and protected?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Fuel stored envirnmentaly safe?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Refueling opertaions environmentally safe?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• All plant and equipment secured?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Is waste being stored correctly and protected?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Are arrangements for waste disposal fully understood and documented?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

Water Courses / Drainage

• Reviewed

  Y

  N

• Spill kits availabe for protection of surface drainage?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Other water courses protected from spillages/leaks?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

Vehicles

• Reviewed

  Y

  N

• If not available in welfare unit. Is the following equipment on vehicle; First aid kit, fire extinguisher, eye wash, hand wash facility or wipes, spill kit?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Vehicles locked and secured?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Engines switched off when not in use?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Vehicle movement on site, does it require banksman and are rules/signs being followed?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

Site Operations

• Activities being carried out on site

Small Plant and Tools

• Are all necessary tools available?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Are tools and equipment being used correctly?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Are tools and equipment in good order and useable?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Has plant been inspected and have tags/records?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Dust suppression available and fit for purpose?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

Lifting operations

• Reviewed

  Y

  N

• Are materials being double handeled - if so could methods be improved?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Is correct equipment available on site?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Is the equipment being used correctly?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

Hot works

• Reviewed

  Y

  N

• Do operatives have sufficient training?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Is the work being marshalled to ensure safety?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

Working at Heights

• Reviewed

  Y

  N

• Have operatives been provided with sufficient training?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Has equipment been inspected with records and tagged?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

• Is equipment being used correct for the job?

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

Lone working

• Reviewed

  Y

  N

• Ensure compliance with policy document

  Select Meets Requirements Below Requirements - Minor defect for recommendation Below Requirements - Major defect

  • Meets Requirements
  • Below Requirements - Minor defect for recommendation
  • Below Requirements - Major defect

Compliance

• To achieve minimum score of 90%

  Compliant

  Non-Compliant

Inspecting officer

• Name

• Signature

  Sign

Other Inspecting

• Name

• Signature

  Sign

• Company

• Position / Role

Recomendations

• Item 1

• Action assignee

• Major / Minor

  Minor

  Major

• Rectification

• Due Date

  Date

• Item 2

• Action assignee

• Major / Minor

  Minor

  Major

• Rectification

• Due Date

  Date

• Item 3

• Action assignee

• Major / Minor

  Minor

  Major

• Rectification

• Due Date

  Date

• Item 4

• Action assignee

• Major / Minor

  Minor

  Major

• Rectification

• Due Date

  Date

• Item 5

• Action assignee

• Major / Minor

  Minor

  Major

• Rectification

• Due Date

  Date

• Item 6

• Action assignee

• Major / Minor

  Minor

  Major

• Rectification

• Due Date

  Date

• Item 7

• Action assignee

• Major / Minor

  Minor

  Major

• Rectification

• Due Date

  Date

• Item 8

• Action assignee

• Major / Minor

  Minor

  Major

• Rectification

• Due Date

  Date