Title Page

  • Conducted on

  • Prepared by

  • Location
  • Nature of Work being Undertaken

Details Team Being Inspected

  • Employer / Contractors Name

  • Name of Supervisor / Team Leader

  • Names of Other Team Members

  • JFL Supervisor is on Site

  • Photograph any issues prior to site set up (damage to property, infrastructure, parked cars etc)

  • Personal Protective Equipment

  • All Site Members have appropriate minimum PPE

  • PPE being used is in good condition and being used appropriately

  • All site members understood the importance of the PPE, how to store/ care for it and replace it.

  • Respirators are suitable for the task being undertaken ie correct filters type and level of protection.

  • Respirators are suitable for the individuals wearing it - enable get a face seal or powered respirator

  • Face fit test proof available where required.

  • None disposable RPE is maintained correctly - demonstrate monthly recorded inspection.

  • Test 1

  • Test 2

  • Management Controls to be Reviewed -POWRA, Permits, RAMS etc

  • Has a Suitable Risk Assessment or Point of Work Risk Assessment being completed.

  • Are Site specific RAMS available on site and are work force aware of these

  • Have suitable control measure been identified, understood and being followed by all team members

  • Site Induction Undertake by Site team

  • Training Records and Competency of Site Team Available

  • Site set up to be reviewed

  • Streetworks assessment undertaken and signing lighting and guarding set up appropriately.

  • Information board clearly displayed and appropriate highways permit number displayed.

  • Suitable arrangements in place pedestrians, including signage, ramps and guards.

  • Vulnerable groups have been identified and suitable controls provided.

  • Traffic management in place and working effectively

  • Sand bags provided on signs and guards - appropriate to conditions.

  • Guards are securely clipped and adequate for site.

  • There is a suitable safety zone provided - to protect the site team or additional separation if required to protect the public.

  • Excavation and Service avoidance to be reviewed

  • Permit to Dig completed and all site team aware of controls

  • Are all utility plans available on site and can the team demonstrate they have used these

  • Have the site team identify scaring, utility furniture and property connections / boxes to enable them it identify safe digging locations.

  • CAT and Genny available on site - with evidence of service and calibration

  • Site team demonstrated effective use of CAT and Genny - used all 4 modes for initial survey - clipped on to BT poles/street lights etc.

  • Identified utilities have been clearly marked within and close to the digging area eg paint spray, flags or posts.

  • Trial holes have been undertaken by hand before use of mechanical methods such as mole plough, chain trencher.

  • Safe digging methods identified and being used - appropriate for the location.

  • Spoil has been placed in a safe location to avoid surcharge and having regard for damage

  • Cat and Genny being used effectively as the team dig - minimum of 150mm

  • Is there evidence of exposure utilities being protected form damage - supported, protection boards etc.

  • Temporary works, access and edge protection provided when necessary - suitable design demonstrated.

  • Deep excavation has been battered or stepped back to provide suitable protection against collapse

  • Plant and Equipment being used on Site

  • There are trained and competent operators on site - can demonstrate appropriate training

  • Plant or Equipment has received a suitable daily or per-use inspection

  • Plant or Equipment has received suitable servicing, PAT test, inspection or LOLER examination

  • Plant and equipment is in good order and provided with suitable guards.

  • Plant /Equipment being used correctly having regard for health, safety and environmental risk.

  • Electrical equipment used is 110 volt or battery operators to ensure safety of users.

  • Plant and equipment correct stored and secured for transporting in van, truck or trailer

  • Diggers secures by 3 ratchet straps in good condition or other suitable system.

  • Good House Keeping being Reviewed

  • Vehicles in good order - no smoking stickers displayed, tidy and clean

  • Site maintained in a tidy condition, tools/plant and materials stored to avoid tip hazards

  • The ground conditions are maintained clear of mud, chemical slippages or other slip hazards.

  • Site set up having regard for safety - good layout and placement of spoil etc

  • Plant and materials all contained within barriers.

  • Welfare Facilities being Reviewed

  • Suitable washing facilities are on site - including hot water, soap, hand cream and sanitizer

  • Site team could demonstrate that they were aware of WC facilities available within easy reach

  • Suitable arrangements in place to enable site team to have food and drink having regard to weather conditions.

  • Emergency Arrangements and Facilities being Reviewed

  • Suitable first aid kits and eye wash available on site

  • First aiders are available on site and known to site team.

  • Suitable fire extinguisher available on site

  • Trained personnel are available who can use the fire extinguishers available

  • Emergency plan is in place appropriate for the type of work being undertaken - eg work at height, confined space

  • COSHH - Hazardous Substances in Use

  • COSHH assessments for hazardous substances are available on site

  • All site members using hazardous substances were taking suitable precautions and using correct PPE

  • Fuel and other hazardous substances are stored correctly -secure and suitable bunds

  • Precautions are taken when using refuelling plant - undertaken on nappy sacks

  • Dust Generation Activities in Progress

  • All site members have received training about the risk of dust and understand the which operations could generate hazardous dust.

  • Equipment suitable for the task and has correct cutting piece/ blade for task

  • Suitable dust supression methods used for all operations which can generate hazardous dust - cutting, drill etc

  • Manual Handling Activities being Undertaken

  • All Site members have received manual handling training and understand the importance of correct posture.

  • Site team have parked the vehicle to reduce the distance plant and equipment needs to be carried

  • Site team have reduced the need for manual handling by use of mechanical aids or modifying method

  • Manual handling activities seen on site follow good ergonomic techniques.

  • Vibration Exposure is Relevant to the Work being Undertaken and is to be Reviewed.

  • Operators of mechanical hand operated tools understand the risk of vibration.

  • Operatives have received training about the health risks and how to reduce the risk of injury.

  • Operators understand the vibration levels of equipment and time of use to maintain their exposure to below 2.5m/s2 100 points

  • Operators understand the vibration levels of the equipment and ensure they do not exceed 5m/s2 or 400 points

  • Operatives have received health surveillance medicals appropriate to the use and conditions relating to vibration exposure.

  • Operatives understood controls in cold weather and were taking suitable steps to reduce the risk

  • Operatives understand the importance to share tools to reduce individual exposure

  • There is evidence of vibration monitoring and vibrations levels recording on equipment

Other Issues / Good Practice observed

  • Issues / Good Practice Observed

  • Photographs of issues / Good Practice

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.