Information

  • Store name and number:

  • Client:

  • User:

  • Location:
  • Contractor:

  • Project Type:

  • Date and Time on:

  • Date and Time off:

  • No:

  • Weather:

  • Work in Progress:

1. Security / Induction

  • Have all engineers signed in and out of the visitors register?

  • Reason:

  • Are all engineers carrying ISG Photo ID and wearing Tesco branded Hi visibility vests?

  • Please take photo of an engineer with Hi vis vest (Tesco Branded) and holding up Photo ID:

  • Reason:

2. Documentation / PTW

  • Has the store permit to work been completed?

  • Please take photo:

  • Has the duty manager been made aware of the works to be carried out?

  • Insert name of the manager:

  • Reason

3. Fire Plan & Emergency Procedures

  • Are operatives aware of the store fire plan?

  • Please take photo of the fire escape plan:

  • Reason

  • Are MOE clear and accessible?

  • Reason

  • For occupied stores is there a requirement for a revised fire risk assessment, has the store manager been consulted / staff made aware?

  • All stores will be occupied during these works and trading. Minor works will not affect store FRA.

4. Accident & Reporting

  • Has the First Aider and the First Aid facilities been identified on site?

  • First aider name and contact details:

  • Do you have a copy of the ISG accident form ?

  • Have there been any reportable accidents or near misses on site ?

  • Please add details of the incident:

  • Please complete accident report and pass to line manager

5. Risk Assessments & Method Statements

  • Do you have a copy of the RAMS documentation for this work?

  • Reason:

  • Are the RAMS Site/Project specific?

  • Reason:

  • Are the RAMS suitable?

  • Reason:

  • Have the RAMS been received in good time?

  • Have they been communicated to the operatives and signed as understood?

  • Please take photo of document:

6. Specific Assessments - COSHH, Noise, Vibration

  • COSHH assessments & MSDS on site, stored, used & disposed of correctly?

  • THERE ARE NO COSHH MATERIALS ON THIS PROJECT

7. Store Wide Considerations / Operations

  • Have the correct barriers been used to segregate the works areas from customer and Tesco staff?

  • Please take photo of the barriers:

  • Is appropriate PPE provided and used?

  • Hi Vis Vest?

  • Reason:

  • Hard Hat?

  • Reason:

  • Safety Footware?

  • Reason

  • Safety Glasses?

  • Reason:

  • Gloves?

  • Reason:

  • Ear Protection?

  • Reason:

  • Are site operations conducted safely and in line with method statements?

  • Reason:

  • Is housekeeping in good order & the site free of trip hazards and are materials / waste stored safely?

  • Reason:

8. Tools & Equipment

  • Is the equipment right for the job, including access equpiment?

  • Are they in good order?

  • Reason:

  • Please take photo:

  • Is electrical equipment 110v or lower and tested?<br>Are inspection/test certificates or registers on site?

  • Reason:

9. High Level Working

  • Is high level working being carried out safely and<br>have control measures been implemented?

  • Reason:

  • Are barriers applicable?

  • Please take photo:

  • Comment why the barriers aren't applicable:

  • Have banks men been utilised when access machines are in motion

  • Reason:

10. Asbestos

  • Have you been informed of the rag status of this store and made aware of the ensafe comments?

  • Please state the RAG status?

  • State a reason why you are not aware?

  • Is the Asbestos report available on site?

  • Reason:

  • Do you have sufficient information to proceed with the caution?

11. Performance Beyond Compliance

  • Were there any elements of where the works was not completed due to Health & safety implications?

  • Comments:

  • Does this site meet or exceed industry H&S standards?

Summary

  • Comments:

  • Summary:

  • Distribution:

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.