Health Check Visits

• Conducted on

  Date

• Prepared by

• Location
  Address

Section 1 - Site Setup and Storage

• 1.1   Is there a safe means of access and egress to/from the site and compound?

  Yes

  No

  N/A

• 1.2   Are site security measures adequate, including the provision of secure perimeter fencing where required?

  Yes

  No

  N/A

• 1.3   Are walkways/pedestrian routes maintained in a safe condition?

  Yes

  No

  N/A

• 1.4   Has the site compound and/or set up been properly organised?

  Yes

  No

  N/A

• 1.5   Is  there a suitable office for Site Management to work from?

  Yes

  No

  N/A

• 1.6   Have adequate storage facilities/areas been provided and have materials and equipment been stored in a safe manner? (no risk of falling material)

  Yes

  No

  N/A

• 1.7   Have adequate welfare facilities been provided on site for the current and foreseen workforce, and are they maintained to a clean/suitable standard?

  Yes

  No

  N/A

• 1.8   Is there a designated secure area for skips/waste?

  Yes

  No

  N/A

• 1.9   Is there adequate signage displayed, including an external information board and internal project board?

  Yes

  No

  N/A

• 1.10 Are all significant risks and impacts identified and controlled?

  Yes

  No

  N/A

Section 2 - Public Protection and Community Relations

• 2.1 - Are all significant hazards in areas where the public have access controlled? E.G Access to work Areas and site perimeter.

  Yes

  No

  N/A

• 2.2 - Is balcony protection installed where required? If so is this adequate and maintained?

  Yes

  No

  N/A

• 2.3 - Is temporary floor protection adequately managed?

  Yes

  No

  N/A

• 2.4 - Is adequate warning signage provided for the public?

  Yes

  No

  N/A

• 2.5 - Where existing lighting is obscured/disconnected/removed have alternatives been provided?

  Yes

  No

  N/A

• 2.6 - Is segregation of public carried out using suitable pedestrian barriers with tapping rail where applicable?

  Yes

  No

  N/A

• 2.7 - Are emissions from processes adequately controlled (noise / dust / fumes)?

  Yes

  No

  N/A

• 2.8 - Are all significant risks and impacts identified and controlled?

  Yes

  No

  N/A

Section 3 – Administration and Management (Health and Safety)

• 3.1 - Is the Construction Phase SHE Plan available and regularly reviewed and updated if required?

  Yes

  No

  N/A

• 3.2 - Are all works in progress covered by a suitable and sufficient Risk Assessment and Method Statement?

  Yes

  No

  N/A

• 3.3 Is there evidence that RAMS are briefed to the workforce?

  Yes

  No

  N/A

• 3.4 - Does the site have suitable First Aid cover and complete first aid supplies relevant to works on site with the contents in date?

  Yes

  No

  N/A

• 3.5 - Is statutory information displayed on the project board (F10, HSE poster, insurance, policies, nearest hospital and eye clinic)?

  Yes

  No

  N/A

• 3.6 - Have all previous Corrective Actions been closed out from previous visits? (GO Visits, Health Checks)

  Yes

  No

  N/A

• 3.7 - Have permits to work been used correctly where required and are they recorded on the permit log?

  Yes

  No

  N/A

• 3.8 - Have statutory inspections been carried out as required and are they filed, including SHE weekly inspections?

  Yes

  No

  N/A

• 3.9 - Is there a process for signing in/out? And is this process being followed.

  Yes

  No

  N/A

• 3.10 - Is there evidence that all people have been inducted on site using the Induction DVD/PowerPoint Presentation and site-specific project board?

  Yes

  No

  N/A

• 3.11 - Have all relevant bulletins and TBT been briefed? To include manual handling, gas safety and asbestos awareness where required

  Yes

  No

  N/A

• 3.12 - Are records of all competences being maintained?

  Yes

  No

  N/A

• 3.13 - Are site wide risk assessments completed and required risk assessments in place?

  Yes

  No

  N/A

• 3.14 - Does the Site manager have the necessary competencies for site?

  Yes

  No

  N/A

• 3.15 - Are records of incidents and complaints maintained? Visits by regulatory agencies recorded and communicated to the SHE Team?

  Yes

  No

  N/A

• 3.16 - Is there evidence of Near Misses and observations being reported on site?

  Yes

  No

  N/A

• 3.17 - Is there evidence of monthly MSV's being undertaken and communicated to site teams?

  Yes

  No

  N/A

Section 4 – Workplace and Housekeeping

• 4.1 -  Are walkways clear, unobstructed and free from significant risks?

  Yes

  No

  N/A

• 4.2 -  Are lighting levels adequate in walkways and work areas? Including task lighting where required.

  Yes

  No

  N/A

• 4.3 -  Is housekeeping to an adequate level?

  Yes

  No

  N/A

• 4.4  - Is all work equipment, material and waste in work areas stored in a safe condition?

  Yes

  No

  N/A

• 4.5 -  Is cable management adequate?

  Yes

  No

  N/A

• 4.6 -  Is the potential of falling from height adequately controlled?

  Yes

  No

  N/A

• 4.7  - Is the potential of falling objects adequately controlled?

  Yes

  No

  N/A

• 4.8 -  Is the interface between different trades suitably managed to prevent exposure to risks from others?

  Yes

  No

  N/A

• 4.9 - Are all significant risks in workplaces controlled?

  Yes

  No

  N/A

Section 5 – Scaffolding

• 5.1 - Is the scaffold free from significant defects? (including ties, tubes and fittings, foundations and boards)?

  Yes

  No

  N/A

• 5.2 - Are incomplete sections of scaffold signed?

  Yes

  No

  N/A

• 5.3 - Is any area where there is a risk from falling objects closed off?

  Yes

  No

  N/A

• 5.4 - Are all ladders fixed in position and of correct orientation?

  Yes

  No

  N/A

• 5.5 - Where ladder hatches are installed are they kept closed?

  Yes

  No

  N/A

• 5.6 - Are brick guards fixed where required?

  Yes

  No

  N/A

• 5.7 - Is debris netting and/or monoflex in place where required, and fixed correctly?

  Yes

  No

  N/A

• 5.8 - Is there evidence that scaffolds are made safe at the end of each working day?

  Yes

  No

  N/A

• 5.9 - Has the competency of scaffolders been checked? Copies of CISRS cards must be on site.

  Yes

  No

  N/A

• 5.10 - Are scaffolders working to SG4:15? E.g. advanced guardrail and correct fall arrest.

  Yes

  No

  N/A

• 5.11 - Is housekeeping during scaffold erection and dismantling managed?

  Yes

  No

  N/A

• 5.12 - Are relevant compliance sheets available or the design drawings and calculations for 'design' scaffolds?

  Yes

  No

  N/A

• 5.13 - Have scaffolds been erected in accordance with TG20:21 or the design?

  Yes

  No

  N/A

• 5.14 - Is the scaffold handover certificate available, are details correct and is scaffold being used in line with the handover certificate?

  Yes

  No

  N/A

• 5.15 - Are test results available for drilled in fixings and calibration certificates available?

  Yes

  No

  N/A

• 5.16 - Have inspections been carried out as required?

  Yes

  No

  N/A

• 5.17 - If a gin wheel is in use are LOLER certificates available?

  Yes

  No

  N/A

• 5.18 - Are all significant risks and impacts identified and controlled?

  Yes

  No

  N/A

Section 6 - Mobile Towers and Other Access Equipment

• 6.1 - Has the most appropriate form of access equipment been chosen?

  Yes

  No

  N/A

• 6.2 - Have overhead obstructions been considered?

  Yes

  No

  N/A

• 6.3 - Is the access equipment sat on a level and stable foundation?

  Yes

  No

  N/A

• 6.4 - Are those erecting and/or responsible for mobile towers or other access platforms competent?

  Yes

  No

  N/A

• 6.5 - Are access platforms erected in accordance with manufacturer’s instructions?

  Yes

  No

  N/A

• 6.6 - Are incomplete platforms marked as incomplete?

  Yes

  No

  N/A

• 6.7 - Are hop-ups, steps and ladders of the correct type / grade and their use adequately controlled?

  Yes

  No

  N/A

• 6.8 - Where ladders are used as a work platform, is there a suitable risk assessment for this and control measures implemented?

  Yes

  No

  N/A

• 6.9 - Is equipment being stored correctly when not in use?

  Yes

  No

  N/A

• 6.10 - Is all equipment in good order?

  Yes

  No

  N/A

• 6.11 - Are copies of inspections for all access equipment available?

  Yes

  No

  N/A

• 6.12 - Are all significant risks and impacts identified and controlled?

  Yes

  No

  N/A

Section 7 – Powered Access Equipment

• 7.1 - Is the equipment appropriate for the task?

  Yes

  No

  N/A

• 7.2 - Is the equipment in good condition and fit for purpose?

  Yes

  No

  N/A

• 7.3 - Are all moving parts and controls for operating guarded?

  Yes

  No

  N/A

• 7.4 - Is the SWL, maximum number of persons and maximum operating wind speed indicated on the MEWP? Is this being adhered to?

  Yes

  No

  N/A

• 7.5 - Has safe access into/out of the equipment been considered?

  Yes

  No

  N/A

• 7.6 - Have overhead hazards been considered and adequate controls put in place i.e., exclusion zones, markers or goalposts put in place?

  Yes

  No

  N/A

• 7.7 - Has a suitable exclusion zone been set up using physical barriers and appropriate signage around the MEWP plus taking into account its working envelope?

  Yes

  No

  N/A

• 7.8 - Are the operators of scissor and boom type MEWPS clipped in or is there a risk assessment in place to substantiate otherwise?

  Yes

  No

  N/A

• 7.9 - Are cradle moves being undertaken by competent persons (where required)?

  Yes

  No

  N/A

• 7.10 - Are counterweights for cradles locked in place?

  Yes

  No

  N/A

• 7.11 - Is the equipment isolated and the keys removed when left unattended?

  Yes

  No

  N/A

• 7.12 - Is there a detailed operators manual available on site?

  Yes

  No

  N/A

• 7.13 - Is there an appropriate emergency plan in place?

  Yes

  No

  N/A

• 7.14 - Are certificates of ‘thorough examination’ available on site, and current?

  Yes

  No

  N/A

• 7.15 - Are test results available for drilled in fixings?

  Yes

  No

  N/A

• 7.16 - Is there evidence that pre-use daily and weekly checks on MEWPS, cradles etc. are being carried out?

  Yes

  No

  N/A

• 7.17 - Are those operating MEWPS, plant etc. competent – IPAF?

  Yes

  No

  N/A

• 7.18 - Have copies of operator’s training/competence been copied into the site file?

  Yes

  No

  N/A

• 7.19 - Evidence of familiarity checks for operator?

  Yes

  No

  N/A

• 7.20 - Are all significant risks and impacts identified and controlled?

  Yes

  No

  N/A

Section 8 – Temporary Works

• 8.1 - Have temporary works applicable to the project been identified?

  Yes

  No

  N/A

• 8.2 - Is there an appointed Temporary Works Co-ordinator and Temporary Works Supervisor?

  Yes

  No

  N/A

• 8.3 - Are competencies copied into the site file?

  Yes

  No

  N/A

• 8.4 - Are detailed designs, drawings and calculations available for any temporary works?

  Yes

  No

  N/A

• 8.5 - Is a design check certificate completed and signed off by TWE, TWC and TWS?

  Yes

  No

  N/A

• 8.6 - Is the temporary works register kept up to date?

  Yes

  No

  N/A

• 8.7 - Has permit to load/proceed been completed?

  Yes

  No

  N/A

• 8.8 - Are the works in good order? E.g. Not showing signs of distress and/or excessive deflection.

  Yes

  No

  N/A

• 8.9 - Is there evidence of regular inspections of the temporary works?

  Yes

  No

  N/A

• 8.10 - Have modifications to temporary works been rechecked, with design change application completed?

  Yes

  No

  N/A

• 8.11 - Are all significant risks and impacts identified and controlled?

  Yes

  No

  N/A

Section 9 – Mobile Plant

• 9.1 - Is the plant in good order and suitable for the purpose for which it is provided or used?

  Yes

  No

  N/A

• 9.2 - Is the plant maintained so that it remains mechanically sound and are there records available?

  Yes

  No

  N/A

• 9.3 - Is the plant stable in use? Is there a safe way to get into and out of the cab and any other parts of the vehicle that need regular access?

  Yes

  No

  N/A

• 9.4 - Is the plant being operated in a safe manner? i.e. is the area segregated, hazard light on and banked if required by RA.

  Yes

  No

  N/A

• 9.5 - Are vehicle lights, reversing lights, a horn and other warning devices such as rotating beacons or reversing alarms fitted?

  Yes

  No

  N/A

• 9.6 - Is the plant fitted with Roll Over Protection System (ROPS) where necessary?

  Yes

  No

  N/A

• 9.7 - Are dangerous vehicle parts, such as power take –off, chain drives, exposed hot exhaust pipes appropriately guarded?

  Yes

  No

  N/A

• 9.8 - Is the vehicle suitable for any loads carried?

  Yes

  No

  N/A

• 9.9 - Are seat belts fitted and used correctly?

  Yes

  No

  N/A

• 9.10 - Are mirrors and or closed circuit TV (CCTV) systems fitted and fit for purpose?

  Yes

  No

  N/A

• 9.11 - Is any towing/quick hitch in good order and spares available? – correct pin?

  Yes

  No

  N/A

• 9.12 - Is equipment Manufacturers tag on machine? E.g Plate containing serial number etc

  Yes

  No

  N/A

• 9.13 - Is equipment that may be used for lifting marked with a SWL?

  Yes

  No

  N/A

• 9.14 - If used on the road is the vehicle registered etc and operator has a current UK Driving Licence?

  Yes

  No

  N/A

• 9.15 - Is there a Manufacturers Operation Manual available to the Mobile Plant Operator?

  Yes

  No

  N/A

• 9.16 - Has security been considered and is the unauthorised use of plant prevented?

  Yes

  No

  N/A

• 9.17 - Does the operator hold a CPCS Card or equivalent and is it of the correct type?

  Yes

  No

  N/A

• 9.18 - Has the Mobile Plant Operator Authorisation Checklist been completed?

  Yes

  No

  N/A

• 9.19 - Is equipment that may be used for lifting thoroughly examined/tested and in date?

  Yes

  No

  N/A

• 9.20 - Are daily and weekly checks being carried out and recorded?

  Yes

  No

  N/A

• 9.21 - Are all significant risks and impacts identified and controlled?

  Yes

  No

  N/A

Section 10 – General Work Equipment

• 10.1 - Is the equipment being used for the purpose that it was designed?

  Yes

  No

  N/A

• 10.2 - Are tools and equipment in good condition?

  Yes

  No

  N/A

• 10.3 - Are all safety devices in place and operational?

  Yes

  No

  N/A

• 10.4 - Are whip checks fitted to airlines?

  Yes

  No

  N/A

• 10.5 - Are there suitable work benches/designated cutting areas where required?

  Yes

  No

  N/A

• 10.6 - If there is a requirement for an exclusion zone has this been established?

  Yes

  No

  N/A

• 10.7 - Is there evidence that defective equipment is removed from use?

  Yes

  No

  N/A

• 10.8 - Are there specific assessments for noise, dust and vibration with adequate controls in place?

  Yes

  No

  N/A

• 10.9 - Are test certificates available for specialist equipment?

  Yes

  No

  N/A

• 10.10 - Are maintenance / inspection records available for the equipment?

  Yes

  No

  N/A

• 10.11 - Are operatives competent to use the equipment? Are copies of training records available? E.g. abrasive wheels

  Yes

  No

  N/A

• 10.12 - Are all significant risks and impacts identified and controlled?

  Yes

  No

  N/A

Section 11 – Lifting

• 11.1 - Are all lifting operations reviewed by a competent person and is there a Lifting Plan available where required?

  Yes

  No

  N/A

• 11.2 - Has the lifting plan checklist been carried out, where required?

  Yes

  No

  N/A

• 11.3 - Are lifting operations recorded in the Construction Phase SHE Plan?

  Yes

  No

  N/A

• 11.4 - Is there evidence that the lifting plan is reviewed in meetings for future adaptions to the plan?

  Yes

  No

  N/A

• 11.5 - Are only contract lifts used on site?

  Yes

  No

  N/A

• 11.6 - Are those involved with planning and executing the lift competent as specified by the lifting plan risk assessment?

  Yes

  No

  N/A

• 11.7 - Are required licences obtained? E.g. oversailing near railway lines, over public walkways etc.

  Yes

  No

  N/A

• 11.8 - Are sufficient and appropriate insurance cover arranged for all liabilities, agreed and documented between all parties, before any lifting operations commence?

  Yes

  No

  N/A

• 11.9 - If applicable – Is there a risk assessment in place for an excavator being operated as a crane/hoist and gin wheels?

  Yes

  No

  N/A

• 11.10 - Is there evidence of adequate information, instruction, training and supervision available to all operatives involved in lifting operations?

  Yes

  No

  N/A

• 11.11 - Is there a register of lifting equipment?

  Yes

  No

  N/A

• 11.12 - Are copies of all certificates and training details maintained in the site file?

  Yes

  No

  N/A

• 11.13 - Are test and examination certificates available for all equipment and accessories being used and in date?

  Yes

  No

  N/A

• 11.14 - Is the lifting plan being followed?

  Yes

  No

  N/A

• 11.15 - Is all equipment in good visual order?

  Yes

  No

  N/A

• 11.16 - Are loads stable and secure with no projections and in accordance with the lifting plan?

  Yes

  No

  N/A

• 11.17 - Are lifting operations adequately supervised and carried out in a safe manner?

  Yes

  No

  N/A

• 11.18 - Are height restrictors fixed to cranes / excavators that limit the height to which the job will reach and the limit to which a machine can slew?

  Yes

  No

  N/A

• 11.19- Is the lift area secure? e.g. No lifting over live work areas, pedestrian management or whilst zoning is taking

  Yes

  No

  N/A

• 11.20 - Are competent slinger / signaller / banksman being used and is there an effective system of communication between the operator and the slinger / signaller / banksman?

  Yes

  No

  N/A

• 11.21 - Is the Safe Working Load (SWL) clearly indicated on all cranes and lifting appliances?

  Yes

  No

  N/A

• 11.22 - Has the correct lifting equipment been selected, used and stored in a safe manner? i.e. using a hoist rather than a gin wheel.

  Yes

  No

  N/A

• 11.23 - Is there a record of the telehandler specification and familiarisation record?11.23 - Is there a record of the telehandler specification and familiarisation record?

  Yes

  No

  N/A

• 11.24 - Can the forks of a telehandler be adjusted from within the cab to avoid the need for manual adjusting?

  Yes

  No

  N/A

• 11.25 - Are all significant risks and impacts identified and controlled?

  Yes

  No

  N/A

Section 12 – COSHH

• 12.1 - Have all substances which may be hazardous to health been identified, assessed, SDS available and use controlled?

  Yes

  No

  N/A

• 12.2 - Are hazardous materials being stored in accordance with SDS's and COSHH assessments and recorded on a register?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• 12.3 - Has COSHH information been briefed out to those affected? - Record required.

  Yes

  No

  N/A

• 12.4 - Are control measures identified in COSHH assessment being operated?

  Yes

  No

  N/A

• 12.5 - Are the necessary first aid measures in place?

  Yes

  No

  N/A

• 12.6 - Is the COSHH storage identified on the site plan with appropriate signage displayed?

  Yes

  No

  N/A

• 12.7 - Where substances have WEL/STEL in place is adequate control and surveillance in place?

  Yes

  No

  N/A

• 12.8 - Have harmful products been substituted for less harmful products where possible?

  Yes

  No

  N/A

• 12.9 - Are all significant risks and impacts identified and controlled?

  Yes

  No

  N/A

Section 13 – PPE

• 13.1 - Is all PPE/RPE identified by Risk and COSHH assessments etc. available on site to use?

  Yes

  No

  N/A

• 13.2 – is there a sufficient supply of replacement PPE/RPE, where required?

  Yes

  No

  N/A

• 13.3 - Is all PPE/RPE provided of the correct type/grade?

  Yes

  No

  N/A

• 13.4 – Are records of face fit test certificates kept on site?

  Yes

  No

  N/A

• 13.5 – Where necessary, is there evidence that operatives have been given instruction / training on the use of PPE/RPE?

  Yes

  No

  N/A

• 13.6 – Where required, are there maintenance records available for PPE/RPE?

  Yes

  No

  N/A

• 13.7 – Is there adequate signage in place stating PPE/RPE requirements, where necessary? E.g. ear protection zone.

  Yes

  No

  N/A

• 13.8 – Is PPE/RPE being worn correctly?

  Yes

  No

  N/A

• 13.9 – Does PPE/RPE in use appear in good condition?

  Yes

  No

  N/A

• 13.10 - Are all significant risks and impacts identified and controlled?

  Yes

  No

  N/A

Section 14 – Manual Handling

• 14.1 - Have all manual handling operations been identified, assessed and managed and control measures briefed out?

  Yes

  No

  N/A

• 14.2 - Where mechanical aids been identified within RAMS are they being used?

  Yes

  No

  N/A

• 14.3 - Has manual handling training been provided where required?

  Yes

  No

  N/A

• 14.4 - Are weight of items known? E.g. documented in RAMS or displayed on items

  Yes

  No

  N/A

• 14.5 - Are all significant risks and impacts identified and controlled?

  Yes

  No

  N/A

Section 15 – Noise and Vibration

• 15.1 - Is exposure to noise levels likely to exceed the lower exposure action level of 80db(A) been identified?

  Yes

  No

  N/A

• 15.2 - Has noise above 80 dB (A) been controlled at source where possible?

  Yes

  No

  N/A

• 15.3 - Have hearing protection zones been established for areas where noise exceeds 85 dB (A)? And are these adequately signed?

  Yes

  No

  N/A

• 15.4 - Are hearing protection zones displayed on site plan and has the information on hearing protection zones been briefed out? - Evidence required.

  Yes

  No

  N/A

• 15.5 - Where required has a S61 consent been obtained and is there evidence of monitoring and compliance in accordance with it?

  Yes

  No

  N/A

• 15.6 - Have others who may be affected by the noise been considered and consulted?

  Yes

  No

  N/A

• 15.7 - Does the site or task have working hour restrictions and are these complied with?

  Yes

  No

  N/A

• 15.8 - Has hearing protection been assessed to ensure compliance with other PPE?

  Yes

  No

  N/A

• 15.9 - Has a risk assessment been carried out for vibrating equipment which includes a soundly based estimate of the employees’ exposure to vibration?

  Yes

  No

  N/A

• 15.10 - Have work practices where hand-arm vibration is likely to exceed the daily action value [2.5 m/s² A (8)] been identified with suitable controls in place?

  Yes

  No

  N/A

• 15.11 - Have work practices where whole-body vibration could exceed the daily exposure limit value [1.15 m/s² A (8)] been identified and controlled?

  Yes

  No

  N/A

• 15.12 - Have all operatives been made aware of the risks and control measures in place for Noise and Vibration?

  Yes

  No

  N/A

• 15.13 - Are health surveillance records available where required?

  Yes

  No

  N/A

• 15.14 - Are all significant risks and impacts identified and controlled?

  Yes

  No

  N/A

Section 16 – Fire Prevention

• 16.1 - Has the site developed a written fire plan, drawn fire plan and an associated risk assessment for all work areas and is it sufficient for the workplace?

  Yes

  No

  N/A

• 16.2 - Is there evidence that the fire plan is briefed out and/or included in the induction?

  Yes

  No

  N/A

• 16.3- Is the drawn fire plan displayed on the project board?

  Yes

  No

  N/A

• 16.4 - Is there suitable means of escape and are they kept clear?

  Yes

  No

  N/A

• 16.5 - Are fire points established and maintained?

  Yes

  No

  N/A

• 16.6 - Are fire extinguishers suitable for the types of fire likely to be encountered?

  Yes

  No

  N/A

• 16.7 - Are fire extinguishers serviceable and maintenance records available?

  Yes

  No

  N/A

• 16.8 - Is there suitable means of warning and an interlinked fire alarm where required?

  Yes

  No

  N/A

• 16.9 - Where relevant, emergency arrangements give consideration to other occupiers/users?

  Yes

  No

  N/A

• 16.10 - Are all potential sources of ignition, including waste and fuel identified, stored and controlled adequately?

  Yes

  No

  N/A

• 16.11 - Is the site operating a 'Hot Works' permit system and are the controls detailed within the permit being complied with?

  Yes

  No

  N/A

• 16.12 - Is there a nominated and trained Fire Marshal(s)?

  Yes

  No

  N/A

• 16.13 - Fire Drill held in accordance with the site fire plan?

  Yes

  No

  N/A

• 15.14 - Are all significant risks and impacts identified and controlled?

  Yes

  No

  N/A

Section 17 – Excavations

• 17.1 - Is the service avoidance plan completed and communicated?

  Yes

  No

  N/A

• 17.2 - Is there a record of the service avoidance on site checklist?

  Yes

  No

  N/A

• 17.3 - Has the RAMS for excavation works been issued and relevant for Task?

  Yes

  No

  N/A

• 17.4 - Has service Drawings been obtained or PAS 128 survey been carried out?

  Yes

  No

  N/A

• 17.5 - Has a CAT and Genny been used to establish underground services on site and calibration certificates available?

  Yes

  No

  N/A

• 17.6 - Has training / Competency been obtained for Use of Cat and Genny?

  Yes

  No

  N/A

• 17.7 - Is there a permit to break ground in place?

  Yes

  No

  N/A

• 17.8 -Are excavations properly supported?

  Yes

  No

  N/A

• 17.9 - Is the excavation guarded to prevent people, material and plant falling in?

  Yes

  No

  N/A

• 17.10 - Have stop blocks been provided for plant?

  Yes

  No

  N/A

• 17.11 - Is spoil stored at a safe distance from the sides of the excavation?

  Yes

  No

  N/A

• 17-12 - Has undermining of nearby structures been considered?

  Yes

  No

  N/A

• 17.13 - If other services have been exposed are they adequately protected and supported?

  Yes

  No

  N/A

• 17.14 - Has a safe means of access/egress been provided for the excavation?

  Yes

  No

  N/A

• 17.15 - Is there an emergency procedure in place for excavations?

  Yes

  No

  N/A

• 17.16 - Record of inspections for the excavation available on site?

  Yes

  No

  N/A

• 17.17 - Are all significant risks and impacts identified and controlled?

  Yes

  No

  N/A

Section 18 – Asbestos Management

• 18.1 - Is there asbestos information available and is it adequate for the works being undertaken?

  Yes

  No

  N/A

• 18.2 - Are works in progress covered by a risk assessment and/or plan of work and is the work correctly described and categorised?

  Yes

  No

  N/A

• 18.3 - Is non-licensable 'minor' work being undertaken by competent and trained personnel with the required insurances and approved by Regional SHEQ Manager if not being undertaken by a licenced contractor?

  Yes

  No

  N/A

• 18.4 - Are licensable asbestos works being undertaken by a licensed company?

  Yes

  No

  N/A

• 18.5 - For licenced works, has the HSE been notified using the ASB5 Notification form? Are notifiable non-licenced works notified using ASB NNLW1 notification form?

  Yes

  No

  N/A

• 18.6 - Are there competence records, occupational health records and face fit records for asbestos removal operatives?

  Yes

  No

  N/A

• 18.7 - Has all asbestos information been communicated to relevant personnel?

  Yes

  No

  N/A

• 18.8- Is the potential for accidental release of asbestos fibres identified and controlled?

  Yes

  No

  N/A

• 18.9 - Are site managers carrying out relevant Asbestos Checklists?

  Yes

  No

  N/A

• 18.10 - Has the Site Manager got access to the Emergency Release asbestos procedure and is it understood?

  Yes

  No

  N/A

• 18.11 - Relevant flow charts extracted from the asbestos standards are displayed on the site notice boards?

  Yes

  No

  N/A

• 18.12 - Are all significant risks and impacts identified and controlled?

  Yes

  No

  N/A

Section 19 – Gas Safety

• 19.1 - Have gas appliances and flues been surveyed, identified, tested and documented? (smoke testing)

  Yes

  No

  N/A

• 19.2 - Have works that impact on gas appliances and flues been identified? (e.g. changes to ventilation during window replacement and working within 1m of a live flue)

  Yes

  No

  N/A

• 19.3 - Are all ‘gas works’ undertaken by Gas Safe registered persons? (excludes bayonet fittings)

  Yes

  No

  N/A

• 19.4 - Is there a gas flue ‘Permit to Work’ system in use for all works that impact on live gas flues, and is the system correctly implemented?

  Yes

  No

  N/A

• 19.5 - Is information on GAS SAFE registered persons used on site recorded and easily accessible?

  Yes

  No

  N/A

• 19.6 - Has the Site Manager undertaken the EQUANS Gas Safety training?

  Yes

  No

  N/A

• 19.7 - Are specific risk assessments and method statements available for works which may impact on gas appliances and flues, and are works undertaken in accordance with the planned method of work?

  Yes

  No

  N/A

• 19.8 - Is commissioning paperwork available for all new live appliances?

  Yes

  No

  N/A

• 19.9 - Are gas safe records available for alterations or isolations/reconnections of gas appliances.

  Yes

  No

  N/A

• 19.10 - Have those disconnecting/reconnecting bayonet fittings been trained and records kept? Do they have access to leak detection spray?

  Yes

  No

  N/A

• 19.11- Are the Gas procedures available on site?

  Yes

  No

  N/A

• 19.12 - Are flue tags in use?

  Yes

  No

  N/A

• 19.13 - Are GAS SAFE registrations verified?

  Yes

  No

  N/A

• 19.14 - Does the site paperwork link an individual GAS SAFE registered person back to individual items of work?

  Yes

  No

  N/A

• 19.15 - Are all significant risks and impacts identified and controlled?

  Yes

  No

  N/A

Section 20 – Electrical Safety

• 20.1 -Have RAMS been issued and are relevant for Electrical works on site?

  Yes

  No

  N/A

• 20.2 - Is the need for 'live' working eliminated?

  Yes

  No

  N/A

• 20.3 - Are works in the vicinity of live circuits adequately controlled? (e.g. safe isolation).

  Yes

  No

  N/A

• 20.4 - Has the risk from overhead services or live conductors been identified, and are suitable control measures in place? (e.g. isolation/insulation)

  Yes

  No

  N/A

• 20.5 - Are statutory undertaker’s plans available on site (where relevant)?

  Yes

  No

  N/A

• 20.6 - Are tools and equipment 110v or battery powered?

  Yes

  No

  N/A

• 20.7 - Are test certificates for temporary supplies available?

  Yes

  No

  N/A

• 20.8 - Are all site supplies certified with no visual defects?

  Yes

  No

  N/A

• 20.9 - Are all electrical appliances (including extension cables) PAT tested and in date?

  Yes

  No

  N/A

• 20.10 - Are all significant risks and impacts identified and controlled?

  Yes

  No

  N/A

Section 21 – Traffic Management

• 21.1 - Is there a Traffic Management Plan (written and drawn) in place, implemented and displayed with corresponding risk assessment?

  Yes

  No

  N/A

• 21.2 - Are vehicle and pedestrian routes segregated / protected and signposted where necessary?

  Yes

  No

  N/A

• 21.3 - Is the need for vehicles to reverse either eliminated or managed?

  Yes

  No

  N/A

• 21.4 - Are clearly identified and trained vehicle banksmen used where required?

  Yes

  No

  N/A

• 21.5 - Are Internal / external roads maintained in a clean condition?

  Yes

  No

  N/A

• 21.6 - Are risks to the public adequately controlled?

  Yes

  No

  N/A

• 21.7 - Are there wheel washing facilities available on site where applicable?

  Yes

  No

  N/A

• 21.8 - Are deliveries planned to avoid congestion at site?

  Yes

  No

  N/A

• 21.9 - Are vehicles maintained in a clean and road worthy condition

  Yes

  No

  N/A

• 21.10 - Are all significant risks and impacts identified and controlled?

  Yes

  No

  N/A

Section 22 – Ecology, Archaeology and Heritage

• 22.1 - Has an Aspects and Impacts Register been completed for the project on AIMS? Has it been reviewed as required and is it compliant on AIMS?

  Yes

  No

  N/A

• 22.2 - If required, has a Biodiversity Action Plan been completed and uploaded to the Aspects and Impacts App on AIMS?

  Yes

  No

  N/A

• 22.3 - Have buildings likely to contain protected bats, nesting birds or other species been surveyed by the Client?

  Yes

  No

  N/A

• 22.4 - Has a mitigation programme for protected species been developed and implemented?

  Yes

  No

  N/A

• 22.5 - Have Tree Preservation Orders (TPO) or Client protected trees been identified?

  Yes

  No

  N/A

• 22.6 - Have listed buildings been identified and planning restrictions communicated?

  Yes

  No

  N/A

• 22.7 - Are areas likely to contain archaeological resources been surveyed by the Client?

  Yes

  No

  N/A

• 22.8 - Have areas with noxious and / or invasive plants been identified?

  Yes

  No

  N/A

• 22.9 - Are all significant risks and impacts identified and controlled?

  Yes

  No

  N/A

Section 23 – Water Resource Management

• 23.1 - Have water discharge points been identified and appropriate license in place?

  Yes

  No

  N/A

• 23.2 - Is there an up-to-date drainage plan on site detailing the location of all surface water drains and sewers in and around the site and where they lead? (where appropriate)

  Yes

  No

  N/A

• 23.3 - Is bulk storage of fuel in accordance with oil storage regs?

  Yes

  No

  N/A

• 23.4 - Is Oil / fuel drums maintained in bunded areas?

  Yes

  No

  N/A

• 23.5 - Is there evidence to reflect bunds /storage vessels are maintained to ensure they remain in good condition? Are bunds/storage areas free from rainwater, litter, oil, fuel etc.?

  Yes

  No

  N/A

• 23.6 - Is drainage from the office / canteen facilities to mains sewer or septic tank?

  Yes

  No

  N/A

• 23.7 - Is the drainage system maintained and free from blockages?

  Yes

  No

  N/A

• 23.8 - Are there designated concrete washout areas located away from sensitive areas?

  Yes

  No

  N/A

• 23.9 - Is there evidence of spill clean up training delivered to site personnel, where applicable and spill kit available?

  Yes

  No

  N/A

• 23.10 - Are all significant risks and impacts identified and controlled?

  Yes

  No

  N/A

Section 24 – Waste Management & Carbon

• 24.1 - Have all waste streams been identified and suitable storage obtained?

  Yes

  No

  N/A

• 24.2 - Have all hazardous waste streams been identified and suitable storage obtained?

  Yes

  No

  N/A

• 24.3 - Is all waste stored and segregated where possible with physical barriers and signed?

  Yes

  No

  N/A

• 24.4 - Are Waste Transfer Notes and Consignment Notes held on site for all waste movements and are compliant with correct details?

  Yes

  No

  N/A

• 24.5 - Is there evidence of Internal waste transfer notes and are they completed properly for EQUANS and Subcontractors (where required)?

  Yes

  No

  N/A

• 24.6 - Is there a copy of EQUANS/Subcontractors Waste Carriers Licence in relevant EQUANS/Subcontractors vehicles? And a copy available in the site file?

  Yes

  No

  N/A

• 24.7 - Where possible energy usage (electricity / gas / other site fuel) is monitored and recorded (monthly) on the online recording system.

  Yes

  No

  N/A

• 24.8 - Where required, are waste movements reported on AIMS?

  Yes

  No

  N/A

• 24.9 - Are all significant risks and impacts identified and controlled?

  Yes

  No

  N/A

• Completed By -

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• Received By -

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