Page 1: Initial questions

  • Conducted on

  • Prepared by

  • Location
  • Crew
  • Type of works being undertaken ?

Page 2: HSE Inspection

  • Do workers have a safe route to their place of work on the site?

  • Is the area of work secure so that the technician can carry out their works?

  • Are other people protected from works that are being carried out e.g. with warning signs and barriers?

  • Are Welfare & First-Aid facilities in place and do workers know where they are?

  • Are appropriate safety signs in place e.g. traffic routes?

  • Is there a risk of collapsing trench sides? If yes, is there adequate bracing?

  • Is the work vehicle in good condition?<br>(Photo(s))<br>

  • Is there any safety defects on the workers vehicle? If yes, describe any defects and include photos.

  • Are there beacon lights fitted to the work vehicle? If yes, do they work?

  • Does the worker have all the necessary PPE? If no, what items are the missing/needs replacing?

  • Has the work vehicle got ramps to remove pumps generators etc. ?

  • Is there a First-Aid kit in the works vehicle? If yes, when does it expire?

  • Is there a fire extinguisher in the works vehicle? If yes, when does it need to be serviced?

Equipment Inspection

  • Does the worker have Electrofusion welder ? If yes, what is the number of the welder?

  • Does the worker have Butt Fusion Welder ? If yes what is the number of the welder ?

  • Does the worker have a welding generator ? If yes what is the S/N of the generator ?

  • Is there any equipment with any defects? If yes, please explain?

Additional

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