Title Page
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Contract
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Site conducted
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Conducted on
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Prepared by
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Location
Untitled Page
City conducted:
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PN Number:
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Principle contractor:
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Sub contractor (if applicable):
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Please remember to provide photo evidence for all applicable questions
SLG
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Is advanced warning correct, correctly placed, in acceptable condition and weighted?
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Are barriers erected, weighted appropriately, and securing site on all sides?
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Are the correct sized cones used and placed correctly?
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If Traffic Control is Required, is it correct and fit for purpose?
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Is there clear instruction and information for pedestrians?
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Is there a safe route around the works including any footway boards or T matting which must be appropriately fitted, in good condition and fit for purpose?
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If there is a cycle lane within the works area, have diversion or 'please dismount' signage been provided and displayed?
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Where used, are carriageway ramps or road plates fit for purpose, fixed appropriately and in good condition?
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Has adequate allowance been made in site setup for a safe working area, including within the confines of any traffic management?
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Are materials and equipment that are separate to the work area suitably contained within barriers or fencing?
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Is a CityFibre site information board displayed appropriately, providing the full and correct permit number readable from the footway or safe location?
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Are the permit conditions on site and accessible for all crew and adhered to?
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Is the site set up so it does not cause obstruction (either physical or to visibility for road users or pedestrians crossing) and accounts for the local area? (i.e. Residential or business access, schools, emergency services, disabled parking bays)
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Are there any other high risk failures on site or caused by the works?
Documentation
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Have suitable Site Risk Assessments been conducted, recorded, signed by/briefed to all, for the current operations?
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Are Method Statements/SSoW in use, briefed, and applicable?
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Are utility drawings on site, in date, available, legible and understood?
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Are emergency and environmental incident response processes available on site?
Noticing & Competence
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Is there a Streetworks qualified supervisor on site or available?
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Have Streetworks personnel got the relevant operative certificates available for inspection?
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Are all operatives trained and competent for the task being undertaken? (SA002/CPCS/Abrasive wheels etc)
Welfare
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Are suitable welfare arrangements in place and have locations been communicated?
PPE
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Is PPE being worn correctly and appropriate for the works being conducted?
HSG47
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Are utility markings suitable and clearly visible?
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Is CAT and Genny equipment calibrated, in good working order and being used appropriately?
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Are safe digging processes being followed?
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Are works in proximity to trees following NJUG tree protection zone guidance?
Other Plant & Equipment (excluding CAT and Genny)
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Is all plant and equipment checked as required?
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Is dust suppression being used during cutting activities?
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Is there sufficient protection to prevent falls from height or dropped objects? (including on vehicles where required)
House Keeping
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Are tools, equipment and materials (including contaminated) stored safely and appropriately?
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Are plant, fuelled tools and fuel cans being stored on suitable plant pads, trays or nappies (including when in use) with a spill kit available?
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Are substances stored with appropriate labels and in approved containers?
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Are noise levels on site being controlled/reduced? (PPE, Working hours, equipment choices)
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Is the site swept and in general good order?
Good Practice & Sign Off
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Are there any exceptionally good safety behaviours or standards of work being exhibited?
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Please give a description of the practice you have observed and would like recognised
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Sign Off
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Auditor Signature