H&S Site Audit

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Project Address

• Project Number

• Project Type

• Engineer

• Site Contact Name

• Safe Access

  Yes

  No

  N/A

• Lifting Facilities

  Yes

  No

  N/A

• Tested Lifting Beam

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Equipment Hatch

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Heating

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Ventilation

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Lockable Access Door/Hatch

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Adequate Main Lighting

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Emergency Lighting

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Screening

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Sheave Guard

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Rotating Parts Yellow

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Rope Ferrules

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Guard Rails

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Access Ladders

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Stop Switches

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Guard to Gov, Selector,Comm,Ect

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Tested / Marked Lifting Beam

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Socket Outlets

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Controller Mats

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Controller / Equipment Clearances

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Adequate Labelling

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Handwinding Facility / Brake Release

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Notices

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Wiring Diagrams

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Painting, Sealing of Lift Floor

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Floor Level Indication

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Smoke Detector

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Lock off Mains Isolator

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Fire Extinguisher

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Safety Barriers

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Suspect Asbestos

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Non Lift Services

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Non Lift services

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Are hoardings being used

  Select Comment

  • Comment

• Are all hoardings securely fixed to walls

  Select Yes No N/A

  • Yes
  • No
  • N/A

Shaft Compliance With Health & Safety

• Shaft Division Screen

  Select Comment

  • Comment

• Shaft Lighting

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Gaps to side of Car

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Smoke Vent

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Maintenance Limits

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Notice reduced Headroom

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Car top Controls BS7255 compliant

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Car Top Light

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Car Top Socket

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Trapped on car tops (voids)

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Protection over head pulleys

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Lift car emergency lights

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Well Lifting Beam (H)

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Single Point Hitch

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Notice Reduced Pit Depth

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Notice Descending Counter Weight

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Pit Switch/ Mushroom

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Counterweight Screen

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Pit Socket Outlet

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Pit Ladder

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Pit Prop

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Facia Panels / Toe Guard

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Painting of Shaft

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Ledges in Shaft

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Water in pit area

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Non Lift services

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Open well

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Lattice gates

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Non BS7255 Governor Switch

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Non BS7255 Tension Switch

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Non BS7255 Buffer Switch

  Select Yes No N/A

  • Yes
  • No
  • N/A

Public Safety

• Door Protection

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Slippery Floor

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Slave Door Contacts

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Glass Door Contacts ( Children)

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Assessment Carried out by : Print Name

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