Title Page
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Document No.
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Site title
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ACM
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Prepared by
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Branch
- Bristol
- Birmingham
- Cardiff
- Cornwall
- Exeter
- London
- Southampton
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Contract Manager
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Conducted on
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1.1 Is the plan of work of a good enough standard to proceed and does it reflect the site conditions? (Licensed works, ASB5 attached)
- Yes
- No
- N/A
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Comments:
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If answer is NO, send photo ammendments
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Amendments Comments:
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1.2 Have all site staff been briefed on the contents of the plan of work and informed of risks?
- Yes
- No
- N/A
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Comments:
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Photo of Paperwork:
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1.3 Have other contractors based at this site been briefed on the work?
- Yes
- No
- N/A
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Comments:
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Photo of Paperwork:
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1.4 Do you have copies or access to all of the following documentation? Internal Training certs, Specialist Training certs, Face Fits, 6 Mthly Respirator certs, Mthly Mask checks, Medical certs, Equipment certs
- Yes
- No
- N/A
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Comments:
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Photo:
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1.5 Is the DCU in the best position, operational and in good working order and has: All certs up to date, EZplug, CO2 Alarm, Bull Bar/Wheel Lock, Good Earth and Clean Water filter.
- Yes
- No
- N/A
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Comments :
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Photo of DCU:
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1.6 Is the access(entry) to and egress (exit) from work areas(s), including routes (Transit/Waste) clearly signed with Shield signage and free from debris. Potential hazards marked with hazard tape and controlled areas cordoned off with barrier tape?
- Yes
- No
- N/A
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Comments:
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Photo of routes
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1.7 Does the site board contain the following items: valid Insurance cert & Asbestos License, Waste Carrier License, Site Documentation, Fire Extinguisher, First aid kit, Air horn, Supervisor name & Contact No.
- Yes
- No
- N/A
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Comments :
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Photo of Board:
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1.8 Are the following safety warning signs, as well as barrier tape identifying the asbestos and respirator zones, in place? No Unauthorised Access, Wear RPE, Wear Coveralls, Danger Asbestos
- Yes
- No
- N/A
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Comments :
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Photo of Signage:
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1.9 Has the access equipment been set up correctly, filling in the relevant checklist or risk assessment if necessary? Signatory must have valid training: PASMA for access Tower, IPAF for MEWP, Fixed scaffold: Fit for purpose and Scaff tagged, Confined Space or Restricted access: Assessed and qualified
- Yes
- No
- N/A
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Comments :
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Photo of Paperwork &Equipment:
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1.10 If an external contractor has set up the equipment, do you have copies of the necessary certs?
- Yes
- No
- N/A
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Comments :
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Photo of certs:
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1.11 Has the gas been purged, electrical equipment and lighting been isolated? Do you have copies of the certs?
- Yes
- No
- N/A
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Comments :
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Photo of certs:
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1.12 Has all RPE been checked and has the check sheet been completed?
- Yes
- No
- N/A
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Comments :
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Photo of Paperwork:
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1.13 Are all personnel expected to wear RPE clean shaven? Supervisor, Operatives, Visitors; ie Analyst.
- Yes
- No
- N/A
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Comments :
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Photo:
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1.14 Are all personnel wearing the correct PPE?
- Yes
- No
- N/A
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Comments :
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Photo:
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1.15 Have all points on the daily inspection sheet been checked and sheet completed?
- Yes
- No
- N/A
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Comments:
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Photo:
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Name of Supervisor: