Title Page

  • Project conducted

  • Site ID

  • Site Type

  • Client

  • Subcontractor(s)

  • Subcontractor

  • Subcontractor

  • Inspection Date

  • Site Location
  • Event Manager

  • PICW for site and company they work for

  • Safety Advisor

Summary & Highlights of Audit

  • Good Practice(s)

  • Bad Practice(s)

  • Have field staff & PICW been issued the latest QHSE Bulletins?

Work Environment

  • Arrangements for protection against adverse weather conditions

  • Housekeeping Slips/Trips/Falls

  • Is there a spill kit available on site, attach a photograph

  • Are access routes clearly defined

  • Are materials stored tidily outside access routes

  • Are the significant risks relating to confined spaces controlled

  • Are the significant risks relating to confined spaces controlled

  • Are the significant risks relating to overhead obstructions controlled

  • Are the significant risks relating to overhead obstructions controlled

  • Are the significant risks relating to overhead services controlled

  • Are the significant risks relating to overhead services controlled

  • Are leading edges protected

  • Are leading edges protected

  • Is grillage in good condition with all clips attached?

  • Are significant risks from existing processes controlled

  • Are significant risks from existing processes controlled

  • Are the significant risks relating to contaminated land controlled

  • Are the significant risks relating to contaminated land controlled

  • Has the presence of Asbestos been determined

  • Mechanical hazards (existing processes, lift motor rooms, window cleaning equipment, etc)

  • Mechanical hazards (existing processes, lift motor rooms, window cleaning equipment, etc)

  • Are plant & pedestrians adequately segregated

  • Traffic management plan implemented

  • Is the work area defined & adequately segregated

  • Adequate and suitable arrangements for site security

  • Are the significant risks relating to work adjacent to water controlled

  • Are the significant risks relating to work adjacent to water controlled

  • Is access to prohibited area controlled

  • Are existing fall arrest systems tagged & in date

  • Are existing fall arrest systems tagged & in date

  • Are existing fixed ladders inspected & tagged in date

  • Are existing fixed ladders inspected & tagged in date

  • Are there signs of vermin/animal infestation

  • Does the location/nature of the site present an unacceptable risk to persons security

  • Are there signs of intravenous drug use/paraphernalia

  • Provide photographs

  • Action required

Welfare Arrangements

  • Means for taking rest break available

  • Adequate toilet facilities available

  • Adequate washing facilities available

  • Hot & cold running water available

Emergency Arrangements

  • Adequate means of raising the alarm

  • Evacuation arrangements inc. muster point, adequate & suitable

  • Adequate & suitable trained first aid resource present

  • Fully stocked, in date, first aid box present

  • Emergency contact numbers specified

  • Personnel booked onto site (with both operator & owner/occupier)

  • Owner/occupier emergency arrangements integrated

  • Means for incident reporting

  • Are adequate and suitable fire extinguishers available & inspected in date

  • Are adequate and suitable fire extinguishers available & inspected in date

Rigging Personnel (Add as required)

    Field Engineer
  • Name of engineer & Company

  • Are persons wearing required PPE

  • Are persons complying with SSW requirements

  • Site rules complied with?

  • Is the PICW adequately controlling on site activity & briefed engineer(s)?

  • RF Monitors calibrated, in date and in use on site

  • Does FE have correct authorisation cards and name on documentation to work on site?

  • Is the site an MBNL site? Does FE have mandatory MBNL CTL training cert?

  • Where applicable are all Working at Heights Medicals in date?( Enter expiry Date)

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  • Where applicable is there evidence of Climber training? ( Enter expiry Date)

  • Where applicable is there evidence of Annual Rescue Training? ( Enter expiry Date)

  • Where applicable Is there evidence of Rooftop Training? ( Enter expiry Date)

  • Where applicable is there evidence of RF Training? ( Enter expiry Date)

  • Where applicable is there evidence of Asbestos Awareness Training? ( Enter expiry Date)

  • Where applicable is there evidence of Emergency First Aid/First Aid at Height? (enter expiry date) (Note: Emergency First Aid only for non Nokia climbing tasks)

  • Where applicable is there evidence of Manual Handling Training? (Enter expiry Date)

  • Where applicable is there evidence of DC power Training? (enter expiry date)

General Arrangements, Documents, and Signage

  • Has the Build Manager completed the RAMS checklist?

  • Has an adequate and suitable work activity risk assessment been provided

  • Has an adequate & suitable method statement been provided

  • Has an adequate & suitable manual handling assessment been provided

  • Has an adequate & suitable noise assessment been provided

  • Has an adequate & suitable COSHH assessment been provided

  • Has an adequate & suitable COSHH assessment been provided

  • Is a record of persons inducted available

  • Has an adequate & suitable traffic management/pedestrian management plan been provided

  • Has an adequate & suitable traffic management/pedestrian management plan been provided

  • Has an asbestos management plan been provided

  • Has an asbestos management plan been provided

  • Are construction drawings available on site

  • Are records of portable ladder inspection available

  • Are records of portable ladder inspection available

  • Is F10 being displayed

Lifting Operations

  • Is this section applicable?

  • Is the MEWP operator trained

  • Is the MEWP operator trained

  • Name of Engineer and Company

  • Are persons wearing PPE

  • Evidence of RF training

  • Evidence of First aid training

  • Evidence of manual handling

  • Evidence of Asbestos awareness

  • Evidence of MBNL cert

  • Evidence of Ericsson Card

  • Is the AP/Lift Supervisor trained

  • Is the AP/Lift Supervisor trained

  • Name of engineer and company

  • Are persons wearing PPE

  • Evidence of RF training

  • Evidence of First Aid training

  • Evidence of Rooftop training

  • Evidence of Manual Handling

  • Evidence of Asbestos awareness

  • Evidence of MBNL cert

  • Evidence of Ericsson card

  • Is the Crane operator trained

  • Is the Crane operator trained

  • Name of engineer and company

  • Are persons wearing PPE

  • Evidence of RF training

  • Evidence of first aid training

  • Evidence of manual handling

  • Evidence of asbestos awareness

  • Evidence of MBNL cert

  • Evidence of Ericsson card

  • Name of engineer and Company

  • Are persons wearing PPE

  • Evidence of First aid training

  • Evidence of Manual Handling

  • Evidence of MBNL cert

  • Evidence of Ericsson card

  • Is the Slinger/signaller trained

  • Is the Slinger/signaller trained

  • name of engineer and company

  • Are persons wearing PPE

  • Evidence of RF training

  • Evidence of First aid training

  • Evidence of Rooftop training

  • Evidence of Manual handling

  • Evidence of asbestos awareness

  • Evidence of MBNL cert

  • Evidence of Ericsson card

  • Adequate & suitable method of communication established

  • Has an adequate& suitable lifting operations plan been produced

  • Is an AP or lift supervisor present during lifting activities

  • Are the requirements of the lifting operations plan being implemented

  • Has an adequate & suitable exclusion zone established

  • Are certificates of test & thorough examination available for Lifting appliances (cranes, MEWPS, etc.)

  • Is there a spill kit with the appliance

  • Is there a fire extinguisher with the appliance

  • Is there a first aid kit with the appliance

  • Is lifting equipment marked with its SWL

  • Are lifting equipment inspection records available & in date (6 months)

  • MEWP fall prevention in use

  • MEWP fall prevention in use

  • Is inspected WAH PPE & equipment in use

  • Have plant operators daily inspection sheets been completed

  • Traffic management plan implemented

  • Safe slewing zones established

Excavation

  • Is this section applicable?

  • Are users of service avoidance equipment trained.

  • Are plant operatores trained.

  • Are those issuing permits to dig trained

  • Are Statutory Services drawings available on site

  • Are Statutory Service drawing in date, within last 4 weeks

  • Is the cable avoidance tool calibrated.

  • Have all services been identified, marked on the ground and exposed

  • Has a permit to dig been issued

  • Are insulated hand tools been used for digging

  • Are excavations supported in accordance with method statement

  • Are underground services supported when running through excavation

  • Are excavation access/egress arrangements adequate (inc. emergency)

  • Have measures been taken to prevent plant inadvertently entering excavation (stop boards)

  • Safe excavator slewing zones established

  • Have measures been taken to prevent persons falling into excavations (barriers)

  • Have excavations been inspected and report issued upon being dug at 7 day intervals thereafter or following inclement weather

  • Are certificates of test & thorough examination available for Lifting appliances (excavators, etc.)

  • Have plant operators daily inspection sheets been completed

  • Traffic management plan implemented

  • Air compressors & hoses inspected tested and records available

  • Anti whip connectors in use on hoses

  • HAV Vibration controlled

Working at Height

  • Is this section applicable?

  • Are Rope Access Technicians Trained.

  • Are Rope Access Technicians Trained.

  • Are Advanced Climbers Trained

  • Are Advanced Climbers Trained

  • Have WaH Operatives received Tower/Structural Rescue Training

  • Have WaH Operatives received Tower/Structural Rescue Training

  • Have Operatives Received RF Safety Training

  • Have Operatives Received Rooftop Safety Training

  • Have Operatives Received Rooftop Safety Training

  • Are safe climbing techniques in use

  • Are safe climbing techniques in use

  • Is inspected WAH PPE & equipment in use

  • Are safe techniques in use for the raising/lowering of loads

  • Are safe techniques in use for the raising/lowering of loads

  • Is an adequate & suitable exclusion zone established

  • Is an adequate & suitable exclusion zone established

  • RF exclusion zones observed or RF sources isolated (check outage ref)

  • Are hand tool tethers in use

  • Are hand tool tethers in use

  • Is structural integrity certificate available & in date

  • Is structural integrity certificate available & in date

  • Is fall arrest system "tagged" in date

  • Is fall arrest system "tagged" in date

  • Are records of operatives in date WAH medical available

  • Are records of operatives in date WAH medical available

  • Are lifting equipment inspection records available & in date (6 months)

  • Are lifting equipment inspection records available & in date (6 months)

  • Is lifting equipment marked with its SWL

  • Is lifting equipment marked with its SWL

  • Are any unprotected fragile materials present

  • Are any unprotected fragile materials present

  • Are significant risks presented by any flues controlled

  • Are significant risks presented by any flues controlled

  • Arrangements for rescuing WAH personnel adequate, suitable and known

  • Adequate & suitable tower rescue kit on site

  • Adequate & suitable tower rescue kit on site

Scaffolding

  • Is this section applicable?

Are the scfolders present

  • Are the scaffolders present

  • Engineers name and company

  • are persons wearing PPE

  • Evidence of Industry training certs

  • Evidence of First aid training

  • Evidence of RF training

  • Evidence of rooftop training

  • Evidence of Manual Handling

  • Evidence of asbestos awareness

  • Evidence of MBNL cert

  • Evidence of Ericsson card

  • Is a first aid kit present

  • Is Access safe and suitable for materials?

  • Are there any exposed areas where items could fall?

  • Are the foundations suitable for scaffold erection?

  • Are there suitable points to tie the scaffold too?

  • Are scaffolds within footprint of the building? If not, are exclusions zones or fans in use?

  • Have additional works been completed outside the scope?

  • Has scaffolding been inspected and report issued on first erection and at 7 day intervals thereafter or following inclement weather

  • Has the temporary structure been inspected and a copy of the inspection report available on site.

  • Photo's of completed job

Electrical

  • Is this section applicable?

  • Has a permit to work on or near an electrical system been issued.

  • Engineers name and company

  • Is PPE worn

  • Evidence of First aid training

  • Evidence of RF training

  • Evidence of Rooftop training

  • Evidence of Asbestos awareness training

  • Evidence of Manual Handling training

  • Correct certification? (18th edition, C&G 2391, JIB Card)

  • DC Competency?

  • Evidence of training for those issuing permit to work

  • Has secure isolation been established & proven

  • Has a Lock Out Kit been provided and is it in use.

  • Are PAT records available

  • Electrical tools running at 110v or protected by RCD

  • Is electrical test equipment calibrated in date? (Tester and Voltage Tester)

  • Is there a first aid kit present

  • is there a fire extinguisher present

Environmental

  • Is this section applicable?

  • Is waste correctly segregated

  • Are waste receptacles adequate & suitable for the type of waste being disposed off.

  • Are waste receptacles adequate & suitable for the type of waste being disposed off.

  • Are diesel generators positioned away from water courses/drainage

  • Are diesel generators positioned away from water courses/drainage

  • Is fuel oil being stored in double bunded tanks

  • Is fuel oil being stored in double bunded tanks

  • Spill kit available on site

  • Spill kit available on site

  • Evidence of training in the use of spill kit

  • Evidence of training in the use of spill kit

  • Evidence of waste carriers license

  • Evidence of waste carriers license

  • Evidence of waste transfer note

  • Evidence of waste transfer note

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.