Information

  • Branch / Location

  • Auditor

  • Employees Name

  • Vehicle registration number

  • Type of vehicle

  • Current Mileage

  • Location
  • Date

Revision Information

  • This form is the equivalent to HSF6.2 issue 4 . This form is electronic issue 1 - 18/10/2016

Audit Type

  • Please choose the employee type being audited:

General Vehicle Condition

  • Is the period or mileage since last service satisfactory?

  • The recommended period between services for a Vauxhall car is 24 months or 20,000 miles.

  • Are the tyres within legal limits?

  • Are all the vehicle lights functioning correctly including indicators?

  • Is the vehicle loaded correctly?

  • Is the vehicle interior clean and is a no smoking sign fitted?

  • Is the exterior of the vehicle clean and free of damage?

  • Is the vehicle windscreen in an acceptable condition (check for bad cracks)?

  • Are the windscreen wipers in a serviceable condition and capable of clearing the windscreen?

  • Is the seat and head restraint position in line with company guidelines?

  • Are the parking sensors operating correctly?

Personal protective equipment / uniform

  • Are the employees safety shoes or boots in a satisfactory condition?

  • Is the employees Safety helmet (head protection) in a satisfactory condition?

  • Safety helmet issue date.

  • Please arrange for an appropriate replacement to be issued as soon as practicable

  • Safety helmets to be renewed every four years irrespective of condition.

  • Are the employees gloves (hand protection)in a satisfactory condition?

  • Are the employees goggles / glasses (eye protection)in a satisfactory condition?

  • Are the employees ear defenders (hearing protection)in a satisfactory condition?

  • Is the employees hi-visibility waistcoat in a satisfactory condition?

  • Is the employees dust mask (respiratory protection) in a satisfactory condition?

  • Is the employees first aid kit in a satisfactory condition?

  • Please arrange for an appropriate replacement to be issued as soon as practicable

  • First aid kit expiry date

  • Does the employee have PPE bag or suitable PPE containment?

  • Is the employees asbestos emergency kit in a satisfactory condition?

Documentation and eyesight test

  • Does the employee have a valid identity card?

  • Please ensure an ID card is obtained as the earliest opportunity

  • Expiry date

  • Does the employee hold a valid driving licence

  • Does the employee have an up to date employee EHS handbook?

  • Can the employee correctly read a vehicle number plate 20 metres away?

  • If an employee cannot read a number plate correctly please contact your area HR specialist for further advice.

  • Does the employee have a Car Safety Kit?

  • Is the user / driver aware of the instructions for use of the car fire extinguisher?

  • Please go through the instructions with the driver

  • Car fire extinguisher expiry date

Health and Safety Passports

  • Does the employee hold an ECS or CSCS card?

  • Expiry date

  • Please list any other safety passport including expiry dates that the employee holds:

General Vehicle Condition

  • Is the period or mileage since last service satisfactory?

  • The recommended period between services for a Vauxhall car is 24 months or 20,000 miles.

  • Are the tyres within legal limits?

  • Are all the vehicle lights functioning correctly including indicators?

  • Is the vehicle loaded correctly?

  • Is the vehicle interior clean and is a no smoking sign fitted?

  • Is the exterior of the vehicle clean and free of damage?

  • Is the vehicle windscreen in an acceptable condition (check for bad cracks)?

  • Are the windscreen wipers in a serviceable condition and capable of clearing the windscreen?

  • Is the seat and head restraint position in line with company guidelines?

  • Are the parking sensors operating correctly?

Personal protective equipment / uniform

  • Are the employees safety shoes or boots in a satisfactory condition?

  • Is the employees Safety helmet (head protection) in a satisfactory condition?

  • Safety helmet issue date.

  • Please arrange for an appropriate replacement to be issued as soon as practicable

  • Safety helmets to be renewed every four years irrespective of condition.

  • Are the employees gloves (hand protection)in a satisfactory condition?

  • Are the employees goggles / glasses (eye protection)in a satisfactory condition?

  • Are the employees ear defenders (hearing protection)in a satisfactory condition?

  • Is the employees hi-visibility waistcoat in a satisfactory condition?

  • Is the employees dust mask (respiratory protection) in a satisfactory condition?

  • Is the employees first aid kit in a satisfactory condition?

  • Please arrange for an appropriate replacement to be issued as soon as practicable

  • First aid kit expiry date

  • Does the employee have PPE bag or suitable PPE containment?

  • Is the employees asbestos emergency kit in a satisfactory condition?

Documentation and eyesight test

  • Does the employee have a valid identity card?

  • Please ensure an ID card is obtained as the earliest opportunity

  • Expiry date

  • Does the employee hold a valid driving licence

  • Does the employee have an up to date employee EHS handbook?

  • Can the employee correctly read a vehicle number plate 20 metres away?

  • If an employee cannot read a number plate correctly please contact your area HR specialist for further advice.

  • Does the employee have a Car Safety Kit?

  • Is the user / driver aware of the instructions for use of the car fire extinguisher?

  • Please go through the instructions with the driver

  • Car fire extinguisher expiry date

Health and Safety Passports

  • Does the employee hold an ECS or CSCS card?

  • Expiry date

  • Please list any other safety passport including expiry dates that the employee holds:

General Vehicle Condition

  • Is the period or mileage since last service satisfactory?

  • The recommended period between services for a Vauxhall car is 24 months or 20,000 miles, a van is 25,000 or 24 months

  • Are the tyres within legal limits?

  • Are all the vehicle lights functioning correctly including indicators?

  • Is the vehicle loaded correctly?

  • Is the vehicle interior clean and is a no smoking sign fitted?

  • Is the exterior of the vehicle clean and free of damage?

  • Is the safety screen fitted? <br>Note: All company estate vehicles that carry company stock must have a safety screen fitted.

  • Is the vehicle windscreen in an acceptable condition (check for bad cracks)?

  • Are the windscreen wipers in a serviceable condition and capable of clearing the windscreen?

  • Is the seat and head restraint position in line with company guidelines?

  • Are the parking sensors operating correctly?

Personal protective equipment / uniform

  • Are the employees safety shoes or boots in a satisfactory condition?

  • Is the employees Safety helmet (head protection) in a satisfactory condition?

  • Safety helmet issue date.

  • Please arrange for an appropriate replacement to be issued as soon as practicable

  • Safety helmets to be renewed every four years irrespective of condition.

  • Are the employees gloves (hand protection)in a satisfactory condition?

  • Are the employees goggles / glasses (eye protection)in a satisfactory condition?

  • Are the employees ear defenders (hearing protection)in a satisfactory condition?

  • Is the employees hi-visibility waistcoat in a satisfactory condition?

  • Is the employees dust mask (respiratory protection) in a satisfactory condition?

  • Is the employees first aid kit in a satisfactory condition?

  • Please arrange for an appropriate replacement to be issued as soon as practicable

  • First aid kit expiry date

  • Does the employee have PPE bag or suitable PPE containment?

  • Is the employees asbestos emergency kit in a satisfactory condition?

Documentation and eyesight test

  • Does the employee have a valid identity card?

  • Please ensure an ID card is obtained as the earliest opportunity

  • Expiry date

  • Does the employee hold a valid driving licence

  • Does the employee have an up to date employee EHS handbook?

  • Can the employee correctly read a vehicle number plate 20 metres away?

  • If an employee cannot read a number plate correctly please contact your area HR specialist for further advice.

  • Does the employee have a Car Safety Kit?

  • Is the user / driver aware of the instructions for use of the car fire extinguisher?

  • Please go through the instructions with the driver

  • Car fire extinguisher expiry date

Health and Safety Passports

  • Does the employee hold an ECS or CSCS card?

  • Expiry date

  • Does the employee hold a 1b IPAF Licence?

  • IPAF 1b Expiry Date

  • Does the employee hold a 3a IPAF Licence?

  • IPAF 3a Expiry Date

  • Does the employee hold a 3b IPAF Licence?

  • IPAF 3b Expiry Date

  • Does the employee hold a SPA passport?

  • SPA Expiry

  • Does the employee hold a PASMA card?

  • PASMA Expiry

  • Please list any other safety passport including expiry dates that the employee holds:

General Vehicle Condition

  • Is the period or mileage since last service satisfactory?

  • The recommended period between services for a Vauxhall car is 24 months or 20,000 miles, a van is 25,000 or 24 months

  • Are the tyres within legal limits?

  • Are all the vehicle lights functioning correctly including indicators?

  • Is the roof rack in a serviceable condition and securely fixed to the vehicle?

  • Is the ladder rack and roller securely fixed to the roof rack?

  • Are the ladder clamps in a serviceable condition?

  • Is the vehicle loaded correctly?

  • Is the vehicle interior clean and is a no smoking sign fitted?

  • Is the exterior of the vehicle clean and free of damage?

  • Is the safety screen fitted? <br>Note: All company estate vehicles that carry company stock must have a safety screen fitted.

  • Is the vehicle windscreen in an acceptable condition (check for bad cracks)?

  • Are the windscreen wipers in a serviceable condition and capable of clearing the windscreen?

  • Is the seat and head restraint position in line with company guidelines?

  • Are the parking sensors operating correctly?

  • Is the vehicle livery in a reasonable condition and phone numbers visible?

Personal protective equipment / uniform

  • Does the engineer have a full uniform?

  • Are the employees safety shoes or boots in a satisfactory condition?

  • Is the employees Safety helmet (head protection) in a satisfactory condition?

  • Safety helmet issue date.

  • Please arrange for an appropriate replacement to be issued as soon as practicable

  • Safety helmets to be renewed every four years irrespective of condition.

  • Are the employees gloves (hand protection )in a satisfactory condition?

  • Are the employees goggles / glasses (eye protection) in a satisfactory condition?

  • Are the employees ear defenders (hearing protection) in a satisfactory condition?

  • Is the employees hi-visibility waistcoat in a satisfactory condition?

  • Is the employees dust mask (respiratory protection) in a satisfactory condition?

  • Is the employees first aid kit in a satisfactory condition?

  • Please arrange for an appropriate replacement to be issued as soon as practicable

  • First aid kit expiry date

  • Does the employee have PPE bag or suitable PPE containment?

  • Is the employees asbestos emergency kit in a satisfactory condition?

Company Equipment

  • Does the engineer have ladders with a stabilising device fitted?

  • Are the ladders in a satisfactory condition?

  • Please ensure the ladders are removed from service and replacements are ordered ASAP

  • Ladder inspection Date

  • Have the ladder feet been replaced in the last 12 months?

  • Please arrange to have the feet replaced ASAP

  • Ladder Feet Replacement date

  • Does the engineer have steps?

  • Are the steps in a satisfactory condition?

  • Please ensure the steps are removed from service and replacements are ordered ASAP

  • Steps Inspection date

  • Does the engineer have a safety belt (Working Harness)?

  • Is the Safety belt in a satisfactory condition?

  • Safety belt Inspection Date

  • Is the engineers harness is a satisfactory condition?

  • Please ensure the harness is immediately removed from service and placed into quarantine. Order replacement ASAP

  • Harness Inspection Date

  • Does the engineer have temporary safety barriers and tape?

  • Does the engineer have an "Engineer Working" sign?

Electrical Equipment

  • Does the engineers have a multimeter?

  • Is the engineer's multimeter in a satisfactory condition?

  • Calibration due date

  • Does the engineers have an insulation tester?

  • Is the engineer's insulation tester in a satisfactory condition?

  • Calibration due date

  • Does the engineers have a sound pressure meter?

  • Is the engineer's sound pressure meter in a satisfactory condition?

  • Calibration due date

  • Does the engineer multi function tester?

  • Is the engineer's multi function tester in a satisfactory condition?

  • Calibration due date

  • Does the engineers have a battery tester?

  • Is the engineers battery tester in a satisfactory condition?

  • Calibration due date

  • Is the engineers Martindale voltage tester in a satisfactory condition?

  • Is the engineers Martindale proving unit in a satisfactory condition?

  • Is the engineers electrical lock off kit in a satisfactory condition?

  • Does the engineers have a 110v drill and transformer?

  • Is the engineer's 110v drill and transformer in a satisfactory condition?

  • Portable appliance test due date

  • Does the engineers have a 18v drill charger?

  • Is the engineers drill charger in a satisfactory condition?

  • Portable appliance test due date

  • Does the engineers have a 24v drill charger?

  • Is the engineers drill charger in a satisfactory condition?

  • Portable appliance test due date

  • Does the engineers have a power saw?

  • Is the engineers power saw in a satisfactory condition?

  • Portable appliance test due date

  • Does the engineers have a pipe threading machine?

  • Is the engineer's pipe threading machine in a satisfactory condition?

  • Portable appliance test due date

  • Does the engineers have a heat gun?

  • Is the engineer's heat gun in a satisfactory condition?

  • Portable appliance test due date

  • Does the engineers have a 110v extension lead?

  • Is the engineer's 110v extension lead in a satisfactory condition?

  • Portable appliance test due date

  • Does the engineers have a vacuum cleaner?

  • Is the engineer's vacuum cleaner in a satisfactory condition?

  • Portable appliance test due date

  • Does the engineer have a soldering iron?

  • Is the engineers soldering iron in a satisfactory condition?

  • Does the engineer have a gas cylinder?

  • Is the engineers gas cylinder in a satisfactory condition?

  • Does the engineer have a Bosch PDO 6 Cable/Pipe detector or equivalent?

  • Is the engineers Bosch PDO 6 Cable/Pipe detector or equivalent in a satisfactory condition?

  • Does the engineer have pipe cutters

  • Are the engineers pipe cutters in a satisfactory condition?

Tool kit

  • Has the engineer been issued with a company tool kit?

  • Is the soldering iron present and in a satisfactory condition?

  • Is the set of 6 insulated screwdrivers present and in a satisfactory condition?

  • Is the 75 mm cross screwdriver present and in a satisfactory condition?

  • Are the 2 X 100 mm cross type screwdrivers present and in a satisfactory condition?

  • Is the 75 mm PZ type screwdriver present and in a satisfactory condition?

  • Are the 2 X 100 mm PZ type screwdriver present and in a satisfactory condition?

  • Is the Utility key present and in a satisfactory condition?

  • Are the VDE combination pliers 180 mm present and in a satisfactory condition?

  • Are the VDE diagonal side cutter 160 mm present and in a satisfactory condition?f

  • Are the VDE log nose pliers 160 mm present and in a satisfactory condition?

  • Are the VDE wire stripping pliers 160 mm present and in a satisfactory condition?

  • Is the 150 mm adjustable wrench present and in a satisfactory condition?

  • Is the MM Hex Key Set Ball End 9 pc present and in a satisfactory condition?

  • Is the AF Hex Key Set Ball End 12 pc present and in a satisfactory condition?

  • Is the Hex Ratchet Crimping tool present and in a satisfactory condition?

  • Is the Retractable knife present and in a satisfactory condition?

  • Is the powder coated junior hacksaw present and in a satisfactory condition?

  • Are the 10 X junior hacksaw blades present?

  • Is the Hacksaw frame 300 mm blade present and in a satisfactory condition?

  • Are the Hacksaw blades (300 X 24T) present?

  • Is the Coax stripping tool present and in a satisfactory condition?

  • Is the 450 g claw hammer present and in a satisfactory condition?

  • Is the 1 kg club hammer present and in a satisfactory condition?

  • Is the Elect bolster & guard 60 mm bulk present and in a satisfactory condition?

  • Is the 4 pc soft grip chisel set present and in a satisfactory condition?

  • Is the Plastic hose & pipe cutter 35 mm present and in a satisfactory condition?

  • Is the 225 mm thumb turn pipe wrench present and in a satisfactory condition?

  • Is the 600 mm draper level present and in a satisfactory condition?

  • Is the 5 m X 19 mm measuring tape present and in a satisfactory condition?

  • Is the Waterproof 5 watt hand torch present and in a satisfactory condition?

  • Is the Waterproof 3 watt head torch present and in a satisfactory condition?

  • Is the Heavy duty tool case 20 L present and in a satisfactory condition?

Documentation and eyesight test

  • Does the employee have a valid identity card?

  • Please ensure an ID card is obtained as the earliest opportunity

  • Expiry date

  • Does the employee hold a valid driving licence

  • Does the employee have an up to date employee EHS handbook?

  • Does the employee have up to date job spec./method statements?

  • Does the employee have up to date risk assessments?

  • Does the employee have up to date COSHH assessments?

  • Can the employee correctly read a vehicle number plate 20 metres away?

  • If an employee cannot read a number plate correctly please contact your area HR specialist for further advice.

  • Does the engineer have a Car Safety Kit?

  • Is the user / driver aware of the instructions for use of the car fire extinguisher?

  • Please go through the instructions with the driver

  • Car fire extinguisher expiry date

Health and Safety Passports

  • Does the employee hold an ECS or CSCS card?

  • Expiry date

  • ECS is required for all engineers

  • Does the employee hold a 1b IPAF Licence?

  • IPAF 1b Expiry Date

  • Does the employee hold a 3a IPAF Licence?

  • IPAF 3a Expiry Date

  • Does the employee hold a 3b IPAF Licence?

  • IPAF 3b Expiry Date

  • Does the employee hold a SPA passport?

  • SPA Expiry

  • Does the employee hold a PASMA card?

  • PASMA Expiry

  • Please list any other safety passport including expiry dates that the employee holds:

Audit Closeout

  • Please record any applicable comments:

  • Staff Signature

  • Add signature

  • Auditors Signature

  • Add signature

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