Title Page

  • Site

  • Client

  • O&M Contractor

  • Conducted on

  • Report Prepared by

  • Location
  • Document No.

  • Asset Manager

  • Manpower on site

  • Activities on site

MANAGEMENT - DOCUMENTATION

  • Is Employer's Liability Insurance displayed?

  • Is Health and Safety File available on site?

  • Is H&S law poster displayed?

  • Is Drugs and alcohol policy displayed?

  • Are site safety and environmental rules displayed?

  • Is H&S policy statement displayed?

  • Is site management structure and emergency contacts displayed?

  • As built drawings are available on site?

  • Is O&M manual available?

  • Is accident report book available?

  • Is accident report book kept up-to-date?

  • Is site fenced off?

  • Safety signs available at site entrance?

  • Evidence that all persons on site have been signed in/out?

  • Evidence that all persons on site have been inducted available?

  • Has site available First Aid provisions?

  • Fire evacuation/escape plan displayed?

  • First aid poster displayed?

  • Has site completed an Emergency Response Plan?

  • Is emergency response plan displayed?

  • Have emergency scenarios being tested for effectiveness?

  • Has site completed a Fire Risk Assessment?

  • GS6 goalposts are in place?

  • Which is the condition of internal roads?

  • Are HSE inspections being carried out?

  • Are H&S signages deemed sufficient around site?

  • Is site free from signs of unauthorised entry (e.g. vandalism/graffiti, fly-tipping)?

  • Is smoking area being identified?

  • Are keys secure?

  • Are HV keys secure in SAP key cabinet?

SAFE SYSTEMS OF WORK

  • Has site completed a Risk Assessment?

  • Have all contractors submitted Risk Assessments and Method Statements for their activities?

  • Have Risk Assessments and Method Statements being reviewed and approved by Site Rep?

  • Have all workers being briefed on the contents of the Risk Assessments and Method Statements?

  • Are workers competent to undertake their duties?

  • Are all working areas and walkways free from trip hazards?

  • Are all working areas and walkways adequately lit?

  • Are all workers wear the required PPE?

  • Is there a system is in place to monitor the presence of lone, or out of hour’s workers?

COSHH

  • Are Material Safety Data Sheet (MSDS) available for substances that are hazardous to health?

  • Are COSHH assessments available for substances that are hazardous to health?

  • Are all COSHH items secured correctly?

PLANT & EQUIPMENT

  • Do operators carry out plant inspections on a daily basis?

  • Are all electrical equipment PAT tested?

  • Are PAT certificates in date?

  • Do all plant have maintenance records available?

  • Are all unattended plant, ladders and equipment immobilised to prevent unauthorised use?

  • Is small tools register being kept up-to-date?

  • Is CAT & Genny being used prior braking ground?

  • Is CAT & Genny being accompanied by a calibration certificate?

  • Is calibration certificate in date?

  • Is CAT & Genny being operated by competent personnel?

  • Are fire extinguishers available?

  • Have been commissioned on site by a certified fire services company?

  • Monthly visual checks of fire extinguishers are being carried out?

  • Are fire extinguishers being serviced on an annual basis by a certified fire services company?

  • Are lifting equipment in good order?

  • Have lifting equipment certificates of thorough examination?

  • Are certificates of thorough examination in date?

  • Is sufficient number of banksmen on site?

  • Are hand tools in good working order?

  • Are fuel cans correctly stored and labelled?

WELFARE & HYGIENE

  • Is number of toilets sufficient for site personnel?

  • Is number of canteens sufficient for site personnel?

  • Is number of drying rooms sufficient for site personnel?

  • Is hygiene being observed in the welfare cabins?

  • Are means of heating food and water sufficient for site personnel?

  • Is soap available?

  • Is drinking water available?

  • Are non drinking water signs displayed on faucets (toilets & canteens)?

  • Is there water supply available on toilets & canteens?

  • Is designated parking area being identified?

WORKING AT HEIGHT

  • Have all contractors submitted Risk Assessments and Method Statements for working at height activities?

  • Are Working at Height Permits to work being enforced?

  • Are harnesses available and used where appropriate?

  • Is there adequate edge protection to stop people or materials falling?

  • Are areas cordoned off and with signs in place, where persons working at height?

  • Are powered access equipment being used by competent person(s) in agreed locations?

  • Are appropriate ladders being used?

SCAFFOLDS

  • Have all contractors submitted Risk Assessments and Method Statements for activities on scaffolds?

  • Have all alterations and routine inspections being carried out and certified by a competent person?

  • Are handover certificates available for inspection?

  • Is safe access available to the scaffold?

  • Are uprights provided with base plates and sole plates?

  • Are all ledgers braces and struts in position?

  • Is the scaffold secured to minimise the likelihood of collapse?

  • Are guard rails and toe boards being installed in accordance with best practice?

EXCAVATIONS

  • Have all contractors submitted Risk Assessments and Method Statements for excavation activities?

  • Have all excavations been suitably protected to avoid anyone falling in?

  • Have all excavations suitable access/egress including stepping back if necessary?

  • For trenches 1.2m or deeper or if ground conditions/weather conditions dictate or located close to vehicle routes, have the sides of the trench been adequately supported by one of the following: shoring by shielding/other comparable means or benching or battering?

  • Are Permits to work for digging/fencing/pilling being enforced?

  • Are identified utilities clearly marked?

  • Is spoil stored away from excavation?

ELECTRICAL

  • Electricity at work poster available?

  • Electric Shock Treatment poster available?

  • Is the supply voltage for tools and equipment the lowest necessary for the job? (could battery operated tools and reduced voltage systems, e.g. 110V, or even lower in wet conditions, be used)

  • Where mains voltage has to be used, trip devices, e.g. residual current devices (RCDs) are provided for all equipment?

  • Are cables and leads protected from damage by sheathing, protective enclosures or by positioning away from causes of damage?

  • Are electricians competent to undertake their duties?

  • Are Permits to work for electrical works being enforced?

HOT WORKS

  • Have all contractors submitted Risk Assessments and Method Statements for hot works activities?

  • Are Permits to works for hot works being enforced?

  • Are all workers wear the required PPE during hot works?

  • Are suitable fire extinguishers available near hot works?

ENVIRONMENTAL

  • Plants are equipped with spill kits?

  • Are drip trays/plant nappies and spill kits available at refuelling areas?

  • Are drip trays/plant nappies available at plant parking areas?

  • Suitable arrangements for the collecting and disposing of waste?

  • Is waste segregation being achieved?

  • Waste transfer notes provided by waste contractors and logged into the site folders?

  • Are licensed waste management companies being used?

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.