Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Site audit report

Site/Situation

  • 1) Has crew got vehicle pack and filled in?

  • 2) Have operatives Logged onto site?

  • 3) Have all Operatives received briefing of Work Instruction or RAMS? Has at least one person checked all site requirements (staff and equipments) are accounted for before leaving for site?

  • 4) Is TM set up to site requirements of Chapter 8?

  • 5) NRSWA, will any person on footpath/road from any direction understand what is happening and what is expected of them?

  • 6) Are all vehicles parked safely without causing unnecessary obstruction?

  • 7) Is the work area protected by a physical barrier (cones, roping, boards, plastic barriers)?

Equipment

Equipment

  • 8) Lifting keys present, correct size and in good order?

  • 9) First aid kit and eyewash - present, complete and in date

  • 10) Is safety equipment relevant for this site/in calibration/ dated correctly

  • 11) Condition of jetting hose and fittings / wash down hose / auxiliary hose

  • 12) Condition of suction hose and couplings

  • 13) Electrical equipment all PATested?

  • 14) Are ladders serviceable plus stable, properly secured and tagged?

  • 15) If fire extinguisher is present, is it inspected and in date?

  • 16) If trailer is being used to transport equipment, has a light board been fitted? Has a safety chain been used? Are items on the trailer securely placed?

  • 17)Is cctv equipment in good working order?

  • 18) Gas monitors, in date? Used correctly/appropriately?

  • 19) Tripod or Davit Arm, and winch, in date and set up correctly?

  • 20) Harness and lanyard, in date, used appropriately?

  • 21) Stoppers (pipe bungs) correct size/use, inflation kit, being monitored?

  • 22) Communication equipment available ( phones or radios)? State which, have Operatives checked signal as per our MS

H&S - E&Q

H&S E&Q

  • 22) Does crew have positive attitude to safety and compliant with company procedures?

  • 23) Is the working area clean and tidy?

  • 24) Is the correct PPE for all staff on the site (hard hat, visor, goggles, overalls, hi viz, safety boots, gloves)?

  • 25) Is PPE in good condition and being worn at time of audit?

  • 26) Have crew received IWJS induction and if required, induction by client?

  • 27) Do crew have correct training for works being carried out?

  • 28) Has dynamic risk assessment been completed and is it relevant and adequate for the work being carried out?

  • 29) Have operatives agreed on the method used for the works being undertaken and signed on to the DRA?

  • 30) Is the gang pack available and up to date, are contents understood and the contents page signed

  • 31) Are operatives acting responsibly by not putting themselves or others at risk?

  • 32) Welfare facilities ( access to sink and running water, local or on vehicle)? Are the facilities clean and in good order? Are local facilities being used? State which

  • 33) Are lone working procedures in operation? If so are they working correctly?

Compliance - vehicle

Vehicle

  • 1) Daily checks sheet/defect sheet completed?

  • 2) Defects recorded - new, should vehicle have left the yard

  • 3) Defects recorded - ongoing? Is the issue being dealt with, and is the vehicle safe to use?

  • 4) Cleanliness - is the cab clean and tidy, nothing able to roll under pedals etc?

  • 5) Cleanliness - trays and lockers

  • 6) Cleanliness - bodywork

  • 7) Condition of electrical cables and controls?

  • 8) Competence in operation of equipment

  • 9) Vehicle suited to the job in hand?

  • 10) Awareness of vehicle weight and height (Height warning in place)

  • 11) Warning signage in place and legible (Vulnerable Road Users/Cyclists, Bypass Valve, Operational Instructions)

  • 12) O license disc in place

Compliance - documents

Documents

  • 13) Transfer note

  • 14) Work pack / work instruction

  • 15) Permit to work / permit to enter CS

  • 16) Drivers hours book / tachographs/previous 28 days

  • 17) Identity cards (UU, Thames Water, AW, etc)

  • 19) NRSWA red book (October 2013 version)

  • 20) Leptospirosis card, is it legible?

  • 21) Driver CPC card?

  • 22) Tachograph Card?

Vehicle stock list

Stock list

  • 1) Are an appropriate number of the correct cones / size available?

  • 2) Stand pipe and storage bag (Is the Standpipe in the bag, if not in use?)

  • 3) Are correct jetting nozzles available, stored correctly and in good order?

  • 4) Are appropriate hand tools available and in good order?

  • 5) Is spillage kit available?

  • 6) Carrying chapter 8 signage etc?

  • 7) Spare gloves and clothing?

  • 8) Digital camera or camera phone?

Remedial action

  • Details of remedial action required.

  • Person assigned to remedial action.

  • Date required by

  • Select date

  • Signature upon completion of stated requirements

  • Comment.

Photos

  • Add media

  • Add media

  • Add media

  • Add media

  • Add media

  • Add media

Signatures

  • Auditors signature

  • Employees signature

  • Employees signature

  • Employees signature

  • Employees signature

  • Employees signature

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.