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• Document No.

• Name of Contractor:

• Conducted on:

  Date

• Auditor

• Site Contact:

• Location
  Address

• Contract:

• Sites Serviced:

• What are the main risks identified from the audit?

• Areas to follow up:

• Audit score:

• Overall audit summary:

Background Information

• EA check complete?

  Safe

  Low Risk

  High Risk

  N/A

• HSE check complete?

  Safe

  Low Risk

  High Risk

  N/A

• VOSA check complete?

  Safe

  Low Risk

  High Risk

  N/A

• Any other relevant checks under taken?

  Safe

  Low Risk

  High Risk

  N/A

Financial Information

• Has a Dunn and Bradstreet risk review been undertaken?

  Yes

  No

  N/A

• What is the risk score?

• Have the company Directors been subject to a Director check?

  Yes

  No

  N/A

• Have they been Directors of any other companies?

  Yes

  No

  N/A

• Previous company information:

Company

• Previous company name:

• Previous company details:

• Have they been the Director of an insolvent company?

  Yes

  No

  N/A

• Have they been disqualified as acting as a Company Director in the past?

  Yes

  No

  N/A

1.1 Site Information

• 1.11 Does the SP have a valid waste carriers licence?

  Safe

  Low Risk

  High Risk

  N/A

• Waste carrier licence information:

Waste carriers licence

• Name of registered carrier:

• Registered as:

• Registration number:

• Licence address:

  Select Head Office Main Site Secondary Site

  • Head Office
  • Main Site
  • Secondary Site

• Date of registration:

• Date of expiry:

• 1.12 Does the SP have a valid site permit or exemption?

  Safe

  Low Risk

  High Risk

  N/A

• Site permit?

  Safe

  Low Risk

  High Risk

  N/A

• Permit/Licence number:

• Date of application:

• Licence address:

  Select Head Office Main Site Secondary Site

  • Head Office
  • Main Site
  • Secondary Site

• Permit details:

• Exemption?

  Safe

  Low Risk

  High Risk

  N/A

• Exemption reference:

• Date of exemption:

• Licence address:

  Select Head Office Main Site Secondary Site

  • Head Office
  • Main Site
  • Secondary Site

• Exemption details:

• 1.13 Is the SP registered as a hazardous waste producer?

  Safe

  Low Risk

  High Risk

  N/A

• Registration reference:

• Start date:

• Expiry date:

1.2 Transport Information

• 1.21 Does the SP have an operators licence?

  Safe

  Low Risk

  High Risk

  N/A

• Licence number:

• Licence address:

  Select Head Office Main Site Secondary Site

  • Head Office
  • Main Site
  • Secondary Site

• Date issued:

• Review date:

• Last review date:

• Number of vehicles:

• Number of trailers:

• 1.22 Does the SP have valid MOT certificates? (2 examples)

  Safe

  Low Risk

  High Risk

  N/A

• MOT certificate information

MOT certificate

• Test certificate number:

• Vehicle:

• Start date:

• End date:

• 1.23 Does the SP have a weigh bridge calibration certificate?

  Safe

  Low Risk

  High Risk

  N/A

• Date tested:

• Weigh bridge serial number:

• Test certificate number:

• Result:

• 1.24 Are the SP's vehicles fitted with GPS tracking systems?

  Safe

  Low Risk

  High Risk

  N/A

• 1.25 Are the SP's vehicles fitted with a Safe Cycle system? (e.g. FORS scheme in London)

  Safe

  Low Risk

  High Risk

  N/A

2.1 Insurance Documentation

• 2.11 Does the SP have valid insurance documentation?

  Safe

  Low Risk

  High Risk

  N/A

• Insurance document information:

Insurance

• Type of Insurance:

• Insurer:

• Policy holder:

• Policy number:

• Issue date:

• Expiry date:

3.1 Waste Transfer Documents

• 3.12 Does the SP maintain waste transfer notes?

  Safe

  Low Risk

  High Risk

  N/A

• Waste transfer note information:

Waste transfer note

• Site name:

• Date:

• EWC code:

• SIC code:

• Commitment to waste heirachy:

• Description of the waste:

• Waste producer details:

• Signature of waste producer:

• Waste transferee details:

• Signature of waste transferee:

• Final disposal details:

• Signature of final disposal:

• All comments given below are the answers provided by the Service Provider. SP signature is required to confirm the information provided in Section 4.0 is correct to the best of their knowledge.

4.1 Complaints

• 4.11Has the SP received any complaints from local businesses or residents?

  Safe

  Low Risk

  High Risk

  N/A

4.2 EA Notices/Breaches

• 4.21 Has the SP been issued with any improvement notices or breaches of legislation over the last 12 months?

  Safe

  Low Risk

  High Risk

  N/A

• Date of last EA audit:

• 3.22 Does the SP have a copy of the EA audit?

  Safe

  Low Risk

  High Risk

  N/A

4.3 RIDDOR

• 4.31 Has the SP reported any RIDDOR incidents?

  Safe

  Low Risk

  High Risk

  N/A

• SP signature:

  Sign

5.1 Policy Statements

• 5.11 Does the SP have a Health and Safety Policy statement?

  Safe

  Low Risk

  High Risk

  N/A

• Date:

• Management endorsement:

• 5.12 Does the SP have an Environmental Policy?

  Safe

  Low Risk

  High Risk

  N/A

• Date:

• Management endorsement:

• 5.13 Does the SP have a Data Protection Policy?

  Safe

  Low Risk

  High Risk

  N/A

• Date:

• Management endorsement:

• 5.14 Does the SP have a Corporate Social Responsibility Policy?

  Safe

  Low Risk

  High Risk

  N/A

• Date:

• Management endorsement:

• 5.15 Does the SP have an Equal Opportunities Policy?

  Safe

  Low Risk

  High Risk

  N/A

• Date:

• Management endorsement:

• 5.16 Does the SP have a Lone Working Policy?

  Safe

  Low Risk

  High Risk

  N/A

• Date:

• Management endorsement:

5.2 Health and Safety

• 5.21 Does the SP have a designated Health and Safety representative?

  Safe

  Low Risk

  High Risk

  N/A

• Name of representative:

• Any relevant qualifications:

• 5.22 Does the SP have a Health and Safety handbook?

  Safe

  Low Risk

  High Risk

  N/A

• Issue date:

• Review date:

• Management endorsement:

• Document control:

5.3 Risk Assessments

• 5.31 Has the SP carried out risk assessments?

  Safe

  Low Risk

  High Risk

  N/A

• On site risk assessments?

  Yes

  No

  N/A

• Name of risk assessment:

• Start date:

• Review date:

• Document control:

• Hazards highlighted:

• Control measures:

• Off site risk assessments?

  Yes

  No

  N/A

• Name of risk assessment:

• Start date:

• Review date:

• Document control:

• Hazards highlighted:

• Control measures:

5.4 Business Continuity

• 5.41 Does the SP have a Business Continuity/ Disaster Plan?

  Safe

  Low Risk

  High Risk

  N/A

• Issue date:

• Review date:

• Owner/Author:

• On site and off site procedures?

• Tested or desktop based?

6.1 Procedures

• 6.11 Does the SP have any emergency procedures in place?

  Safe

  Low Risk

  High Risk

  N/A

• 6.12 Does the SP have a valid fire certificate?

  Safe

  Low Risk

  High Risk

  N/A

• 6.13 Has the SP produced Method Statements/Safe Working Practises/ Safe Operating Procedures?

  Safe

  Low Risk

  High Risk

  N/A

• On site procedures?

  Yes

  No

  N/A

• Name of procedure:

• Start date:

• Review date:

• Document control:

• Off site procedures?

  Yes

  No

  N/A

• Name of procedure:

• Start date:

• Review date:

• Document control:

6.2 Employee Communication

• 6.21 How does the SP communicate policies and procedures to employees?

  Safe

  Low Risk

  High Risk

  N/A

7.1 Training Documents

• 7.11 Does the SP provides regular training for employees?

  Safe

  Low Risk

  High Risk

  N/A

• Internal training:

• External training:

• 7.12 Does the SP have a training matrix?

  Safe

  Low Risk

  High Risk

  N/A

• Dates trained:

• Refresher training dates:

8.1 Waste Streams

• What M&S waste streams do the SP handle?

• What process does the SP use on site?

• What waste streams are produced at the end of the process?

8.2 Residual Waste

• 8.21 Does the SP produce any residual waste from M&S waste?

  Safe

  Low Risk

  High Risk

  N/A

• Type of residual waste:

• % of residual waste:

• Final destination of waste:

9.1 Subcontractor Information

• The risk ranking for the contractors identified in the following section is subject to change if the sub-contractors are identified as a high risk.

• 9.11 Does the SP utilise sub-contractors/ third parties on M&S waste? (For each waste stream and hauliers)

  Safe

  Low Risk

  High Risk

  N/A

• Sub-contractor/ Third party details:

Sub-contractor

• Name of contractor:

• Waste handled:

• How does the SP choose a contractor?

• How does the SP monitor their sub contractors?

• Are KPIs set?

• Does the Sub contractor require and audit?

  Yes

  No

  N/A

• Contact name:

• Email address/Phone number:

• Date of audit:

• Audit ref:

10.1 Certificates

• 10.12 Does the SP have any certifications?

  Safe

  Low Risk

  High Risk

  N/A

• Certificate information:

Certificate

• Type of certificate:

• Start date:

• Expiry date:

10.2 Awards

• 10.21 Does the SP have any awards?

  Safe

  Low Risk

  High Risk

  N/A

• Awards information:

Award

• Type of award:

• Start date:

• Expiry date:

11.1 Site Facilities

• 11.11 Is the site secure? (Give details)

  Safe

  Low Risk

  High Risk

  N/A

• 11.12 Are visitors requested to sign in and off site?

  Safe

  Low Risk

  High Risk

  N/A

• 11.12 Is the site clean and well maintained? (Give details)

  Safe

  Low Risk

  High Risk

  N/A

11.2 Site Safety

• 11.21 Is PPE used correctly in site?

  Safe

  Low Risk

  High Risk

  N/A

• 11.22 Are site speed limits adhered to?

  Safe

  Low Risk

  High Risk

  N/A

• 11.23 Is the waste stacked correctly?

  Safe

  Low Risk

  High Risk

  N/A

• 11.24 Are there any designated walkways?

  Safe

  Low Risk

  High Risk

  N/A

• 11.25 Do they have spillage kits?

  Safe

  Low Risk

  High Risk

  N/A

• 11.26 Are there designated fire points?

  Safe

  Low Risk

  High Risk

  N/A

• 11.27 Is the a safe means of escape?

  Safe

  Low Risk

  High Risk

  N/A

• 11.28 Is the SP displaying the correct H&S poster?

  Safe

  Low Risk

  High Risk

  N/A

11.3 Site Observations

• 11.31 Any general observations?

  Safe

  Low Risk

  High Risk

  N/A

• Can the SP confirm that they conform to M&S's zero waste to landfill policy?

  Yes

  No

  N/A

• Signature of SP:

  Sign

• Auditors Signature:

  Sign