Information
-
MEMBER COMPANY ON SITE?
-
undefined
-
MEMBER COMPANY
-
SITE ADDRESS
-
CONTRACTS MANAGER
-
SITE MANAGER/SUPERVISOR
-
SITE NUMBER
-
Prepared by
-
DATE/TIME
SITE SET UP
-
RATING
- NOT APPLICABLE
- COMPLIANT
- MINOR NON-COMPLIANCE
- MAJOR NON-COMPLIANCE
- WORK STOPPED 1
- WORK STOPPED 2
- WORK STOPPED 3
-
Perimeter Fencing/Signage/Security
-
Traffic Management (Plan in place and up to date?)
-
Storage/Housekeeping
-
Other
WELFARE FACILITIES
-
RATING
- NOT APPLICABLE
- COMPLIANT
- MINOR NON-COMPLIANCE
- MAJOR NON-COMPLIANCE
- WORK STOPPED 1
- WORK STOPPED 2
- WORK STOPPED 3
-
Canteen
-
Hot/Warm Running Water
-
Hygeine/Soap/Towels etc
-
Toilets
-
Boiling Water/Heating Food
-
Other
DOCUMENTATION
-
RATING
- NOT APPLICABLE
- COMPLIANT
- MINOR NON-COMPLIANCE
- MAJOR NON-COMPLIANCE
- WORK STOPPED 1
- WORK STOPPED 2
- WORK STOPPED 3
-
Construction Phase Plan
-
Risk/COSHH Assessments/Method Statements
-
F10 (expiry date)
-
H & S Law Poster
-
Insurance Certificate
-
Notice Board (take photo)
-
Induction Records
-
Permits
-
Temporary Works (Register, Designs, Checks etc)
-
Other
WORK AT HEIGHT
-
RATING
- NOT APPLICABLE
- COMPLIANT
- MINOR NON-COMPLIANCE
- MAJOR NON-COMPLIANCE
- WORK STOPPED 1
- WORK STOPPED 2
- WORK STOPPED 3
-
Edge Protection
-
Ladders/Stepladders
-
Soft Landing Systems/Nets
-
Trestles
-
Harness/Lanyard
-
Stairwells/Openings in Floors
-
Low level access (podiums/hop ups)
-
Other
SCAFFOLD
-
RATING
- NOT APPLICABLE
- COMPLIANT
- MINOR NON-COMPLIANCE
- MAJOR NON-COMPLIANCE
- WORK STOPPED 1
- WORK STOPPED 2
- WORK STOPPED 3
-
Scaffold Access/ladders
-
Scaffold Suitability
-
Scaffold - General Condition
-
Scaffold Inspections/Handover Certificates
-
Scaffold Design
-
Scaffold Signage
-
Scaffold Ties/Stability
-
Scaffolders Competency
-
Other
MOBILE ACCESS TOWERS
-
RATING
- NOT APPLICABLE
- COMPLIANT
- MINOR NON-COMPLIANCE
- MAJOR NON-COMPLIANCE
- WORK STOPPED 1
- WORK STOPPED 2
- WORK STOPPED 3
-
Training/Competence
-
General Condition
-
Inspection/Tags
-
Other
OCCUPATIONAL HEALTH HAZARDS
-
RATING
- NOT APPLICABLE
- COMPLIANT
- MINOR NON-COMPLIANCE
- MAJOR NON-COMPLIANCE
- WORK STOPPED 1
- WORK STOPPED 2
- WORK STOPPED 3
-
Dust
-
Noise
-
Vibration
-
Asbestos/Asbestos Surveys
-
Lead
-
Manual Handling
-
Other
LIFTING OPERATIONS
-
RATING
- NOT APPLICABLE
- COMPLIANT
- MINOR NON-COMPLIANCE
- MAJOR NON-COMPLIANCE
- WORK STOPPED 1
- WORK STOPPED 2
- WORK STOPPED 3
-
Lifting Plan
-
Certification
-
Inspections
-
Competency
-
Other
ELECTRICITY/PORTABLE TOOLS
-
RATING
- NOT APPLICABLE
- COMPLIANT
- MINOR NON-COMPLIANCE
- MAJOR NON-COMPLIANCE
- WORK STOPPED 1
- WORK STOPPED 2
- WORK STOPPED 3
-
Leads/Cables/Plugs
-
PAT Testing/Inspection
-
Other
PPE
-
RATING
- NOT APPLICABLE
- COMPLIANT
- MINOR NON-COMPLIANCE
- MAJOR NON-COMPLIANCE
- WORK STOPPED 1
- WORK STOPPED 2
- WORK STOPPED 3
-
Head
-
Eye
-
Hands
-
Respiratory Protective Equipment (RPE)
-
Hearing
-
Feet
-
Hi-viz
-
Other
FIRE/EMERGENCIES/FIRST AID
-
RATING
- NOT APPLICABLE
- COMPLIANT
- MINOR NON-COMPLIANCE
- MAJOR NON-COMPLIANCE
- WORK STOPPED 1
- WORK STOPPED 2
- WORK STOPPED 3
-
Fire Risk Assessment/Action Plan
-
Escape Routes/Signs
-
Fire Extinguishers
-
Inspections (weekly checks)
-
Fire Drill
-
First Aid
-
Accident Book
-
Other
EXCAVATIONS/EARTHWORKS
-
RATING
- NOT APPLICABLE
- COMPLIANT
- MINOR NON-COMPLIANCE
- MAJOR NON-COMPLIANCE
- WORK STOPPED 1
- WORK STOPPED 2
- WORK STOPPED 3
-
Underground/Overhead Services
-
Shoring/Battering/Benching
-
Edge Protection
-
Inspections
-
Confined Spaces
-
Other
ENVIRONMENTAL ISSUES
-
RATING
- NOT APPLICABLE
- COMPLIANT
- MINOR NON-COMPLIANCE
- MAJOR NON-COMPLIANCE
- WORK STOPPED 1
- WORK STOPPED 2
- WORK STOPPED 3
-
Transfer Notes/Licences
-
Contaminated Ground/Water
-
Fuel Storage/Use
-
Spill Response/Containment/Emergencies
-
Other
MEWP'S
-
RATING
- NOT APPLICABLE
- COMPLIANT
- MINOR NON-COMPLIANCE
- MAJOR NON-COMPLIANCE
- WORK STOPPED 1
- WORK STOPPED 2
- WORK STOPPED 3
-
Operator Competence
-
Fall Prevention/Harnesses
-
Certification
-
Inspections
-
Barriers/Signage
-
Other
PLANT & EQUIPMENT
-
RATING
- NOT APPLICABLE
- COMPLIANT
- MINOR NON-COMPLIANCE
- MAJOR NON-COMPLIANCE
- WORK STOPPED 1
- WORK STOPPED 2
- WORK STOPPED 3
-
Operator Competence
-
Inspections
-
Maintenance/Certification
-
Safe Use
-
Quick Hitches
-
Other
SUBCONTRACTORS
-
RATING
- NOT APPLICABLE
- COMPLIANT
- MINOR NON-COMPLIANCE
- MAJOR NON-COMPLIANCE
- WORK STOPPED 1
- WORK STOPPED 2
- WORK STOPPED 3
-
Documentation
-
Supervision/Competence
-
Housekeeping
-
Other
MANAGEMENT & SUPERVISION
-
RATING
- NOT APPLICABLE
- COMPLIANT
- MINOR NON-COMPLIANCE
- MAJOR NON-COMPLIANCE
- WORK STOPPED 1
- WORK STOPPED 2
- WORK STOPPED 3
-
Comments
FUTURE WORKS LOOK AHEAD
-
Are there proposed works at height, temporary works, excavations or other high risk activities ?
EXAMPLES OF INNOVATIVE OR OUTSTANDING H&S PRACTICES
-
Are there any innovative or outstanding H&S Practices seen on site?
Sign off
-
I confirm I have had the contents of this report explained to me.
-
Member company Manager/Representative
-
Person conducting this inspection
-
In the event that a Member Company is investigated by or on behalf of the Health and Safety Executive, Northern Counties Safety Group will not be liable to the Member Company for the Fees for Intervention paid by the Member Company to the HSE in accordance with the Health & Safety (Fees) Regulations 2012
CLOSE OUT
-
Corrective Actions Carried Out: