Health & Safety Kit inspection - SCCI

Information

Date of Inspection
Engineer Name
Inspected by
Line Manager
Department

Health and Safety Confirmation

Are you fully aware it is your responsibility to carry out a pre-use inspection on your equipment?
Are you fully aware that should you have concerns with equipment dates and/or integrity you should not use it and seek advice from the H&S department immediately?
Are you fully aware of how to set up and use your work at height equipment, including ladders, fall restraint and arrest?
Are you aware of the "potential" consequences to your personal health, safety and we'll being of not using/following, or using incorrectly, the equipment and training you have been provided?
Are you aware of the "potential" consequences to your employment of not using/following or using incorrectly the equipment and training you have been provided? (Failure to follow procedures and training relating to safety will result in disciplinary action being taken and possible termination of employment)
Are you aware that if you're in any doubt regarding tasks you are required to undertake you should stop and seek guidance from your line manager or the H&S department?

Clothing

Hi-Vis Vest present?
Condition
Item is in a poor condition and will need to be replaced as soon as possible. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity.
Photo of item if required
Size required
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity.
Photo of Item if required
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item at the earliest opportunity. H&S manager or Field supervisor to issue item if available or set a reasonable time frame for engineer to purchase.
Size Required
Safety Boots Present?
Condition
Item is in a poor condition and will need to be replaced as soon as possible. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity.
Size Required
Photo of item if required
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity.
Photo of Item if required
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item at the earliest opportunity. H&S manager or Field supervisor to issue item if available or set a reasonable time frame for engineer to purchase.
Size Required
Waterproof Jacket Present?
Condition
Item is in a poor condition and will need to be replaced as soon as possible. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity.
Size Required
Photo of item if required
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity.
Photo of Item if required
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item at the earliest opportunity. H&S manager or Field supervisor to issue item if available or set a reasonable time frame for engineer to purchase.
Size Required
Waterproof Trousers Present?
Condition
Item is in a poor condition and will need to be replaced as soon as possible. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity.
Size Required
Photo of item if required
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity.
Photo of Item if required
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item at the earliest opportunity. H&S manager or Field supervisor to issue item if available or set a reasonable time frame for engineer to purchase.
Size Required
Comments or corrective actions to take place

Personal Protective Equipment. (PPE)

Antiseptic cleaning wipes Present?
Condition
Item is in a poor condition and will need to be replaced as soon as possible. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity.
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity.
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item at the earliest opportunity. H&S manager or Field supervisor to issue item if available or set a reasonable time frame for engineer to purchase.
Latex Gloves Present?
Condition
Item is in a poor condition and will need to be replaced as soon as possible. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity.
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity.
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item at the earliest opportunity. H&S manager or Field supervisor to issue item if available or set a reasonable time frame for engineer to purchase.
Duflex Gloves or suitable hand protection present?
Condition
Item is in a poor condition and will need to be replaced as soon as possible. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity.
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity.
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item at the earliest opportunity. H&S manager or Field supervisor to issue item if available or set a reasonable time frame for engineer to purchase.
Dust masks present?
Condition
Item is in a poor condition and will need to be replaced as soon as possible. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity.
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity.
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item at the earliest opportunity. H&S manager or Field supervisor to issue item if available or set a reasonable time frame for engineer to purchase.
Ear Plugs present?
Condition
Item is in a poor condition and will need to be replaced as soon as possible. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity.
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity.
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item at the earliest opportunity. H&S manager or Field supervisor to issue item if available or set a reasonable time frame for engineer to purchase.
Goggles or suitable eye protection present?
Condition
Item is in a poor condition and will need to be replaced as soon as possible. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity.
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity.
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item at the earliest opportunity. H&S manager or Field supervisor to issue item if available or set a reasonable time frame for engineer to purchase.
Hard Hat & chin strap present?
Condition
Item is in a poor condition and will need to be replaced as soon as possible. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity.
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity.
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item at the earliest opportunity. H&S manager or Field supervisor to issue item if available or set a reasonable time frame for engineer to purchase.
Hearing protection present?
Condition
Item is in a poor condition and will need to be replaced as soon as possible. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity.
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity.
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item at the earliest opportunity. H&S manager or Field supervisor to issue item if available or set a reasonable time frame for engineer to purchase.
Overshoes present?
Condition
Item is in a poor condition and will need to be replaced as soon as possible. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity.
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity.
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item at the earliest opportunity. H&S manager or Field supervisor to issue item if available or set a reasonable time frame for engineer to purchase.
Barrier Tape present?
Condition
Item is in a poor condition and will need to be replaced as soon as possible. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity.
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity.
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item at the earliest opportunity. H&S manager or Field supervisor to issue item if available or set a reasonable time frame for engineer to purchase.
Road Safety Cones present?
Condition
Item is in a poor condition and will need to be replaced as soon as possible. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity.
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity.
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item at the earliest opportunity. H&S manager or Field supervisor to issue item if available or set a reasonable time frame for engineer to purchase.
Signage present? (Inc cabling in progress)
Condition
Item is in a poor condition and will need to be replaced as soon as possible. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity.
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity.
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item at the earliest opportunity. H&S manager or Field supervisor to issue item if available or set a reasonable time frame for engineer to purchase.
Torch present?
Condition
Item is in a poor condition and will need to be replaced as soon as possible. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity.
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity.
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item at the earliest opportunity. H&S manager or Field supervisor to issue item if available or set a reasonable time frame for engineer to purchase.
First Aid Kit present? (Check expiry date)
Plasters present?
Eye Wash bottle present?
Any components missing? If so please detail below
Details
Expiry date
Engineer to source item at the earliest opportunity. H&S manager or Field supervisor to issue item if available or set a reasonable time frame for engineer to purchase.
Comments or corrective actions to take place

Working at Heights Equipment. (WAH)

10mm Ladder tie bolts present?
Condition
If unsure of condition then the H&S manager is to be contacted and asked if they can check engineers item. A photograph can be sent if practical and a decision or a date to check item is to be set and detailed below.
Details
Photo of item
Date H&S Dept will check item
Item is in a poor condition and will need to be replaced immediately. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Comments or corrective actions to take place
Photo of item if required
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity. Anyone found not to have all or the correct working at heights equipment available to use at all times runs the risk of their work being stopped and any future work being provided until the H&S manager or Field supervisor is satisfied that all equipment is correct and in a good condition.
Comments or corrective actions to take place
Photo of Item if required
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item immediately..H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Ladder Straps (Ratchet) present?
Condition
If unsure of condition then the H&S manager is to be contacted and asked if they can check engineers item. A photograph can be sent if practical and a decision or a date to check item is to be set and detailed below.
Details
Photo of item
Date H&S Dept will check item
Item is in a poor condition and will need to be replaced immediately. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Comments or corrective actions to take place
Photo of item if required
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity. Anyone found not to have all or the correct working at heights equipment available to use at all times runs the risk of their work being stopped and any future work being provided until the H&S manager or Field supervisor is satisfied that all equipment is correct and in a good condition.
Comments or corrective actions to take place
Photo of Item if required
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item immediately..H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Rope Grab / Karabina present?
Condition
If unsure of condition then the H&S manager is to be contacted and asked if they can check engineers item. A photograph can be sent if practical and a decision or a date to check item is to be set and detailed below.
Details
Photo of item
Date H&S Dept will check item
Item is in a poor condition and will need to be replaced immediately. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Comments or corrective actions to take place
Photo of item if required
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity. Anyone found not to have all or the correct working at heights equipment available to use at all times runs the risk of their work being stopped and any future work being provided until the H&S manager or Field supervisor is satisfied that all equipment is correct and in a good condition.
Comments or corrective actions to take place
Photo of Item if required
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item immediately..H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Cowstail present?
Serial No:
Date of Manufacture
Expiry Date
Date of Issue (if known)
Photo of Label (if possible)
Condition
If unsure of condition then the H&S manager is to be contacted and asked if they can check engineers item. A photograph can be sent if practical and a decision or a date to check item is to be set and detailed below.
Details
Photo of item
Date H&S Dept will check item
Item is in a poor condition and will need to be replaced immediately. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Comments or corrective actions to take place
Photo of item if required
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity. Anyone found not to have all or the correct working at heights equipment available to use at all times runs the risk of their work being stopped and any future work being provided until the H&S manager or Field supervisor is satisfied that all equipment is correct and in a good condition.
Comments or corrective actions to take place
Photo of Item if required
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item immediately..H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Lanyard present?
Serial No:
Date of Manufacture
Expiry Date
Date of Issue (if known)
Photo of Label (if possible)
Condition
If unsure of condition then the H&S manager is to be contacted and asked if they can check engineers item. A photograph can be sent if practical and a decision or a date to check item is to be set and detailed below.
Details
Photo of item
Date H&S Dept will check item
Item is in a poor condition and will need to be replaced immediately. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Comments or corrective actions to take place
Photo of item if required
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity. Anyone found not to have all or the correct working at heights equipment available to use at all times runs the risk of their work being stopped and any future work being provided until the H&S manager or Field supervisor is satisfied that all equipment is correct and in a good condition.
Comments or corrective actions to take place
Photo of Item if required
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item immediately..H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
10m Rope & Hook present?
Serial No:
Date of Manufacture
Expiry Date
Date of Issue (if known)
Photo of Label (if possible)
Condition
If unsure of condition then the H&S manager is to be contacted and asked if they can check engineers item. A photograph can be sent if practical and a decision or a date to check item is to be set and detailed below.
Details
Photo of item
Date H&S Dept will check item
Item is in a poor condition and will need to be replaced immediately. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Comments or corrective actions to take place
Photo of item if required
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity. Anyone found not to have all or the correct working at heights equipment available to use at all times runs the risk of their work being stopped and any future work being provided until the H&S manager or Field supervisor is satisfied that all equipment is correct and in a good condition.
Comments or corrective actions to take place
Photo of Item if required
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item immediately..H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
8m Rope & Hook present?
Serial No:
Date of Manufacture
Expiry Date
Date of Issue (if known)
Photo of Label (if possible)
Condition
If unsure of condition then the H&S manager is to be contacted and asked if they can check engineers item. A photograph can be sent if practical and a decision or a date to check item is to be set and detailed below.
Details
Photo of item
Date H&S Dept will check item
Item is in a poor condition and will need to be replaced immediately. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Comments or corrective actions to take place
Photo of item if required
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity. Anyone found not to have all or the correct working at heights equipment available to use at all times runs the risk of their work being stopped and any future work being provided until the H&S manager or Field supervisor is satisfied that all equipment is correct and in a good condition.
Comments or corrective actions to take place
Photo of Item if required
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item immediately..H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Harness present?
Serial No:
Date of Manufacture
Expiry Date
Date of Issue (if known)
Photo of Label (if possible)
Condition
If unsure of condition then the H&S manager is to be contacted and asked if they can check engineers item. A photograph can be sent if practical and a decision or a date to check item is to be set and detailed below.
Details
Photo of item
Date H&S Dept will check item
Item is in a poor condition and will need to be replaced immediately. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Comments or corrective actions to take place
Photo of item if required
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity. Anyone found not to have all or the correct working at heights equipment available to use at all times runs the risk of their work being stopped and any future work being provided until the H&S manager or Field supervisor is satisfied that all equipment is correct and in a good condition.
Comments or corrective actions to take place
Photo of Item if required
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item immediately..H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Kit Bag present?
Condition
If unsure of condition then the H&S manager is to be contacted and asked if they can check engineers item. A photograph can be sent if practical and a decision or a date to check item is to be set and detailed below.
Details
Photo of item
Date H&S Dept will check item
Item is in a poor condition and will need to be replaced immediately. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Comments or corrective actions to take place
Photo of item if required
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity. Anyone found not to have all or the correct working at heights equipment available to use at all times runs the risk of their work being stopped and any future work being provided until the H&S manager or Field supervisor is satisfied that all equipment is correct and in a good condition.
Comments or corrective actions to take place
Photo of Item if required
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item immediately..H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Ladder Stand off present?
Condition
If unsure of condition then the H&S manager is to be contacted and asked if they can check engineers item. A photograph can be sent if practical and a decision or a date to check item is to be set and detailed below.
Details
Photo of item
Date H&S Dept will check item
Item is in a poor condition and will need to be replaced immediately. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Comments or corrective actions to take place
Photo of item if required
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity. Anyone found not to have all or the correct working at heights equipment available to use at all times runs the risk of their work being stopped and any future work being provided until the H&S manager or Field supervisor is satisfied that all equipment is correct and in a good condition.
Comments or corrective actions to take place
Photo of Item if required
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item immediately..H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Ladder Stabiliser present?
Condition
If unsure of condition then the H&S manager is to be contacted and asked if they can check engineers item. A photograph can be sent if practical and a decision or a date to check item is to be set and detailed below.
Details
Photo of item
Date H&S Dept will check item
Item is in a poor condition and will need to be replaced immediately. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Comments or corrective actions to take place
Photo of item if required
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity. Anyone found not to have all or the correct working at heights equipment available to use at all times runs the risk of their work being stopped and any future work being provided until the H&S manager or Field supervisor is satisfied that all equipment is correct and in a good condition.
Comments or corrective actions to take place
Photo of Item if required
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item immediately..H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Ladder Leveller present?
Condition
If unsure of condition then the H&S manager is to be contacted and asked if they can check engineers item. A photograph can be sent if practical and a decision or a date to check item is to be set and detailed below.
Details
Photo of item
Date H&S Dept will check item
Item is in a poor condition and will need to be replaced immediately. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Comments or corrective actions to take place
Photo of item if required
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity. Anyone found not to have all or the correct working at heights equipment available to use at all times runs the risk of their work being stopped and any future work being provided until the H&S manager or Field supervisor is satisfied that all equipment is correct and in a good condition.
Comments or corrective actions to take place
Photo of Item if required
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Engineer to source item immediately..H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Ladders present?
Size of Ladders
Ladder number
Condition
If unsure of condition then the H&S manager is to be contacted and asked if they can check engineers item. A photograph can be sent if practical and a decision or a date to check item is to be set and detailed below.
Details
Photo of item
Date H&S Dept will check item
Item is in a poor condition and will need to be replaced immediately. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Comments or corrective actions to take place
Photo of item if required
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity. Anyone found not to have all or the correct working at heights equipment available to use at all times runs the risk of their work being stopped and any future work being provided until the H&S manager or Field supervisor is satisfied that all equipment is correct and in a good condition.
Comments or corrective actions to take place
Photo of Item if required
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Ladders must be checked thoroughly for dents or damage to rungs, side rails, rubber tips, rubber feet and rung locks. Any damage must be reported immediately to H&S manager or Field supervisor
Engineer to source item immediately..H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Is a 2nd set of Ladders to be inspected?
Size of Ladders
Ladder number
Condition
If unsure of condition then the H&S manager is to be contacted and asked if they can check engineers item. A photograph can be sent if practical and a decision or a date to check item is to be set and detailed below.
Details
Photo of item
Date H&S Dept will check item
Item is in a poor condition and will need to be replaced immediately. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Comments or corrective actions to take place
Photo of item if required
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity. Anyone found not to have all or the correct working at heights equipment available to use at all times runs the risk of their work being stopped and any future work being provided until the H&S manager or Field supervisor is satisfied that all equipment is correct and in a good condition.
Comments or corrective actions to take place
Photo of Item if required
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Ladders must be checked thoroughly for dents or damage to rungs, side rails, rubber tips, rubber feet and rung locks. Any damage must be reported immediately to H&S manager or Field supervisor
Step Ladders or small extendable Ladders present?
Type
State Type
Ladder number
Condition
If unsure of condition then the H&S manager is to be contacted and asked if they can check engineers item. A photograph can be sent if practical and a decision or a date to check item is to be set and detailed below.
Details
Photo of item
Date H&S Dept will check item
Item is in a poor condition and will need to be replaced immediately. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Comments or corrective actions to take place
Photo of item if required
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity. Anyone found not to have all or the correct working at heights equipment available to use at all times runs the risk of their work being stopped and any future work being provided until the H&S manager or Field supervisor is satisfied that all equipment is correct and in a good condition.
Comments or corrective actions to take place
Photo of Item if required
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Ladders must be checked thoroughly for dents or damage to rungs, side rails, rubber tips, rubber feet and rung locks. Any damage must be reported immediately to H&S manager or Field supervisor
Engineer to source item immediately..H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Roof Ladder (Cat) present?
Ladder number
Condition
If unsure of condition then the H&S manager is to be contacted and asked if they can check engineers item. A photograph can be sent if practical and a decision or a date to check item is to be set and detailed below.
Details
Photo of item
Date H&S Dept will check item
Item is in a poor condition and will need to be replaced immediately. H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.
Comments or corrective actions to take place
Photo of item if required
Item is acceptable at present however this will need to be replaced soon. If condition worsens then the engineer is to source a replacement at the earliest opportunity. Anyone found not to have all or the correct working at heights equipment available to use at all times runs the risk of their work being stopped and any future work being provided until the H&S manager or Field supervisor is satisfied that all equipment is correct and in a good condition.
Comments or corrective actions to take place
Photo of Item if required
Item is in a good condition and totally fit for purpose. No actions need to be taken.
Ladders must be checked thoroughly for dents or damage to rungs, side rails, rubber tips, rubber feet and rung locks. Any damage must be reported immediately to H&S manager or Field supervisor
Engineer to source item immediately..H&S manager or Field supervisor to issue item if available otherwise engineer will need to source item at the earliest opportunity. Work will need to be stopped and any future work will not be provided until the H&S manager or Field supervisor is satisfied that all and correct working at heights equipment is in a good condition and available to use at all times.

Additional

Completion / Sign off

I confirm that any items that require periodic inspections, such as harness and ladders must be notified to my Line manager or H&S Dept should they require inspection or if I have concerns regarding their suitability, which may include but not limited to condition, defects and damage sustained.

By signing this I / we confirm that the above checks have been carried out and that items are present and available for use. I understand that if any items are missing or are in a bad condition then these items must be sourced immediately as I require or may require them at all times.
Engineer 1
Engineer 2