Title Page
-
Date
-
Name of auditor
-
Site conducted
-
Operative( s)
-
Location
Operative (s)
-
Uniform
- Full Deltron Lifts (DL) Uniform
- Not wearing DL top
- Not wearing appropriate trousers
- Acceptable
- No Uniform
- N/A
-
Tidy & professional
-
ID badge
- Worn & visable
- Damaged & illegible
- Available on request
- Not presented
- Out of date
- Lost
-
Googles, safety glasses
- Acceptable
- Damaged
- Not available
- Available but not with tools on site
- N/A
-
Hard hat (<3 yrs)
-
Bump cap
-
PPE suitable stored
-
Signed in to site
-
Health and welfare of operative
- All good
- Disclosed mental health concerns
- Disclosed physical health concerns
-
CSCS card
-
Safety footwear
-
Hi-Vis Vest (where applic)
- Acceptable
- Damaged
- Dirty
- Not available
- Not suitable
- N/A
-
Suitable gloves
-
Ear protection/ RPE
- Acceptable
- Damaged
- Not available
- Available but not with tools on site
- N/A
- Not suitable for task
-
Hygiene kit
- Complete
- Item requires replenising *pls state
- Kit required
- N/a
Site
-
Welfare facilities
- Available, suitable & clean
- Available but unsuitable/unclean
- Off site
- None available
-
Operative can demo access to google drive for RAMS, etc
- Has access and can demonstrate use
- Has access but caouldnt demonstrate use
- No access
-
Fire precautions
- Available, ext in date, signs posted
- Avail but not indate/sufficient *pls state
- None/ inadeqate *pls state
- N/A
-
Health hazards
- None present
- Asbestos-identified
- Asbestos-suspected
- Phone masts
- Water in pit
- Needles
- Dust-inc silca
- Water towers/ air conditioning units
- Bodily fluids
- Excrement -bat/pigeon, etc. * Pls state
- Mulitple *pls state
- Other *pls state
-
Site specific risk assessment
-
House keeping
- Clean & Tidy
- Unacceptable -Deltron Lift issues
- Unaccertable- caused by others
-
Access/Egress
Equipment
-
Ladder – tagged & checked
-
Electrical equipment
- Not suitable- 240V mains powered
- Suitable, PAT tested and in date
- Suitable, PAT tested but out of date
- Suitable but not PAT tested
- N/A
-
First aid kit
- Stocked & available
- Needs replenishing
- Out of date
- Not present
- First aid kit required
- N/A
-
Lock off/tag out kit
-
Door stopper
-
Hand tools
-
Harnesses
- Good condition
- Requires inspection
- Damaged-quaratine. Replacement needed
-
Hoardings/ Safety barriers
-
Shorting kit
-
Lifting equipment
Vehicle
-
Registration
-
Clean exterior
-
Clean interior
-
Wipers & windows
-
No smoking signs
-
Doors lockable
-
Hazardous subs
-
Battery terminals taped over
- Batteries present and terminals covered over
- Batteries present but terminals exposed
- No batteries present
- N/A
-
Mileage
-
Seat belts secure
-
Lights
-
Horn, mirrors & tyres
- All acceptable
- Damaged tyre(s) *pls state
- Worn tyre(s) *pls state
- Horn not working
- Mirror damaged
- Mirror not present
-
Damage to vehicle
-
Number plates
-
Equipment
-
Other
Sign Off
-
Auditor (Name, Signature & Sign Date)