Information
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Store name and number:
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Client:
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User:
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Location:
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Contractor:
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Project Type:
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Date and Time on:
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Date and Time off:
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No:
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Weather:
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Work in Progress:
1. Security / Induction
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Have all engineers signed in and out of the visitors register?
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Reason:
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Are all engineers carrying ISG Photo ID and wearing Tesco branded Hi visibility vests?
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Please take photo of an engineer with Hi vis vest (Tesco Branded) and holding up Photo ID:
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Reason:
2. Documentation / PTW
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Has the store permit to work been completed?
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Please take photo:
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Has the duty manager been made aware of the works to be carried out?
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Insert name of the manager:
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Reason
3. Fire Plan & Emergency Procedures
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Are operatives aware of the store fire plan?
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Please take photo of the fire escape plan:
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Reason
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Are MOE clear and accessible?
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Reason
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For occupied stores is there a requirement for a revised fire risk assessment, has the store manager been consulted / staff made aware?
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All stores will be occupied during these works and trading. Minor works will not affect store FRA.
4. Accident & Reporting
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Has the First Aider and the First Aid facilities been identified on site?
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First aider name and contact details:
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Do you have a copy of the ISG accident form ?
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Have there been any reportable accidents or near misses on site ?
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Please add details of the incident:
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Please complete accident report and pass to line manager
5. Risk Assessments & Method Statements
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Do you have a copy of the RAMS documentation for this work?
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Reason:
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Are the RAMS Site/Project specific?
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Reason:
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Are the RAMS suitable?
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Reason:
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Have the RAMS been received in good time?
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Have they been communicated to the operatives and signed as understood?
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Please take photo of document:
6. Specific Assessments - COSHH, Noise, Vibration
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COSHH assessments & MSDS on site, stored, used & disposed of correctly?
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THERE ARE NO COSHH MATERIALS ON THIS PROJECT
7. Store Wide Considerations / Operations
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Have the correct barriers been used to segregate the works areas from customer and Tesco staff?
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Please take photo of the barriers:
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Is appropriate PPE provided and used?
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Hi Vis Vest?
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Reason:
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Hard Hat?
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Reason:
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Safety Footware?
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Reason
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Safety Glasses?
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Reason:
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Gloves?
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Reason:
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Ear Protection?
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Reason:
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Are site operations conducted safely and in line with method statements?
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Reason:
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Is housekeeping in good order & the site free of trip hazards and are materials / waste stored safely?
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Reason:
8. Tools & Equipment
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Is the equipment right for the job, including access equpiment?
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Are they in good order?
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Reason:
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Please take photo:
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Is electrical equipment 110v or lower and tested?<br>Are inspection/test certificates or registers on site?
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Reason:
9. High Level Working
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Is high level working being carried out safely and<br>have control measures been implemented?
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Reason:
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Are barriers applicable?
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Please take photo:
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Comment why the barriers aren't applicable:
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Have banks men been utilised when access machines are in motion
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Reason:
10. Asbestos
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Have you been informed of the rag status of this store and made aware of the ensafe comments?
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Please state the RAG status?
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State a reason why you are not aware?
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Is the Asbestos report available on site?
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Reason:
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Do you have sufficient information to proceed with the caution?
11. Performance Beyond Compliance
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Were there any elements of where the works was not completed due to Health & safety implications?
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Comments:
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Does this site meet or exceed industry H&S standards?
Summary
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Comments:
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Summary:
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Distribution: