KELLY COMMUNICATIONS HSQE AUDIT

• DATE OF AUDIT

  Date

• AUDITOR

• REGIONAL / TEAM MANAGER

• CONTRACTOR

• VOD NUMBER

• LOCATION
  Address

• VEHICLE REGISTRATION & CREW NAMES

'BEFORE' PHOTOGRAPHS

• INITIAL PHOTOS OF WORKS & CIRCUMSTANCES

  Yes

  No

  N/A

S001

• Vehicle exterior: CLEAN; SIGNED; DAMAGE FREE; TYRES ALARMS AND LOCKS OK; PARKED APPROPRIATELY AND CONED OFF

  Yes

  No

  N/A

S002

• OPERATIVES WORKING SAFELY / PIT SAFETY; GENERAL NRSWA / SITE LAYOUT / PPE / SPOIL BEHIND BARRIERS / TOOLS & EQUIPMENT INSIDE WORK AREA / COURTESY BOARD IN USE AND LEGIBLE

  Yes

  No

  N/A

S003

• Correct signing & guarding; EQUIPMENT LAYOUT OK

  Yes

  No

  N/A

S004

• Do Ops have strike number? KNOW WHAT TO DO IF THEY HIT A SERVICE? IS THIS NUMBER & TRANSPORT ACCIDENT HOTLINE & PERSONAL ACCIDENT NUMBER ON OPS MOBILE?

  Yes

  No

  N/A

SOO5

• Vehicle Documentation:<br><br>LAMINATED & NECCK VERSIONS OF VF ABSOLUTE RULES & KELLY ZTRs<br>SITE SPECIFIC MS FOR WORKS (Can they telll you what the risks are from MS?)<br><br>Full Job Pack: JOB SPECIFICATIONS; (Box build Specs?)<br>Welfare Arrangements; RAMs; SSRA (Inc. spares); LIST OF AGREED PUBLIC TOILETS; A&E NUMBERS; SASW BOOK; KELLY H&S BOOK; DRIVER HANDBOOK; ENVIRONMENTAL BRIEFINGS; NEAR MISS OBSV CARD<br>

  Yes

  No

  N/A

S032

• GET OPS TO RECITE VF ABSOLUTE RULES & KELLY ZERO TOLERANCE RULES<br>

  Yes

  No

  N/A

S035

• Have the Operatives had their morning safety briefing from their supervisor. What was the subject?

  Yes

  No

  N/A

S011

• IS THERE AT LEAST ONE FIRST AID QUALIFIED PERSON ON SITE? FIRST AID KIT ON VEHICLE; FULLY STOCKED AND IN GOOD CONDITION & CLEAN; EYE WASH IN DATE?

  Yes

  No

  N/A

S037

• Have Operatives follwoed design in job pack can they demonstrate it to the auditor? Are they aware of correct procedure if design needs to change? IE What happens if they have to move a road crossing?

  Yes

  No

  N/A

S016

• SIte Welfare: INDUSTRIAL HAND WIPES; CLEAN WATER BOTTLE; PAPER TOWELS; SOAP; CLEAN WASHING BUCKET; LIST OF TOILETS FOR USE; WHERE DO THEY ABLUTE?

  Yes

  No

  N/A

S017

• Utility Drawings: PRESENT & CORRECT ISSUE FOR WORKS; DATED WITHIN LAST THREE MONTHS; LEGIBLE; A3; COLOUR; USED? UNDERGROUND SERVICES MARKED IN PAINT ON FOOTPATH/HIGHWAY AND SERVICES IDENTIFIED EG HV/LT/BT? HAVE TRIAL HOLES BEEN DUG?

  Yes

  No

  N/A

S030

• CALIBRATED CAT & GENNY (W/LEADS) - SERVICES TRACED & MARKED DETAILS:

  CAT SERIAL NO.

  CAT EXPIRY DATE

  GENNY SERIAL NO.

  GENNY EXPIRY DATE

SO13

• PPE ON VEHICLE? HARD HAT / EAR DEFENDERS / SAFETY GLASSES / GLOVES / BOOTS / HIVIS VESTS / DUST MASK / KNEE PADS / WET WEATHER CLOTHING / FLAME PROOF OVERALLS / REFLECTIVE TROUSERS / ALL IN GOOD CONDITION AND PRESENTABLE

  Yes

  No

  N/A

S014

• OPERATIVES WEARING PPE IN LINE WITH SITE SPECIFIC METHOD STATEMENT?<br>HAS SITE SPECIFIC RISK ASSESSMENT BEEN SIGNED AND DOCUMENTED TO SHOW WHAT PPE THEY WILL WEAR? <br>ARE THEY WEARING FLAME PROOF OVERALLS AND REFLECTIVE TROUSERS?

  Yes

  No

  N/A

S009

• CORRECT SIGNAGE & GUARDING EQUIPMENT ON VEHICLE; X12 CONES / CHECK SLEEVES / <br>ROAD SIGNS (METAL): L/R ARROW, ROAD NARROWS / MAW / PEDESTRIAN ARROW / COURTESY BOARD / FOOTPATH CLOSED / WALK BOARDS / KERB RAMPS - ALL X2 / STACKER BARRIER X8

  Yes

  No

  N/A

S015

• PERSONNEL APPEARANCE OK AND WEARING UNIFORM<br>ALL OPS HAVE ID CARDS / WEILS / NRSWA / CSCS

  Yes

  No

  N/A

S021

• TRAILER; GOOD CONDITION / WORKING LIGHTS / CORRECT PLATE / DAILY INSPECTION RECORDS PRESENT / 3 STRAPS NUMBER PLATE PRESENT / JOCKEY WHEEL & BRAKES WORKING / SNATCH CABLE FITTED AND IN GOOD CONDITION

  Yes

  No

  N/A

S022

• ARE THERE ANY PETROL / DIESEL / 2 STROKE / LIQUIDS IN UNMARKED CONTAINERS? <br>MAX X2 5L PROPRIETARY FUEL CONTAINERS ALLOWED ON VEHICLE / SECURING STRAPS X3 / FIRE EXTINGUISHER (IN DATE) FLAMMABLE LIQUID STICKER ON VEHICLES023

  Yes

  No

  N/A

S023

• KANGO / STIHL SAW WITH H20 BOTTLE & ATTACHEMENTS / BREAKER / TRENCH RAMMER / COMPACTOR PLATE / VIBRATING ROLLER / ALL IN GOOD CONDITION WITH NO LEAKS<br>OPERATIVES HAVE RELEVANT CERTS / CARDS - OBSERVED SAFE USE

  Yes

  No

  N/A

S038

• TARPAULIN FOR HRA ON REAR OF VEHICLE?

  Yes

  No

  N/A

S031

• OPERATIVES HAVE GOOD KNOWLEDGE OF H&S RULES AND CAN ANSWER H&S QUESTIONS

  Yes

  No

  N/A

S019

• PIT LIFTERS - FOOT & CARRIAGE WAY; CORRWCT TYPE AND IN GOOD ORDER

  Yes

  No

  N/A

S024

• ELECTRICAL EQUIPMENT PAT TESTED / CORRECT COLOUR SPRAY

  Yes

  No

  N/A

S007

• GAS MONITOR CALIBRATED & WORKING; BATTERY OK<br>OPERATIVES UNDERSTAND CORRECT USAGE

  GAS MON SERIAL NO.

  GAS MON CALIBRATION EXPIRY

S033

• ARE NEAR MISS CARDS ON VEHICLE? NEAR MISS APP ON SMARTPHONE? DO OPERATIVES UNDERSTAND IMPORTANCE OF REPORTING NEAR MISSES?

  Yes

  No

  N/A

S039

• HAVE BEFORE AND AFTER PHOTOS BEEN TAKEN - POST INSPECTION S040PHOTOGRAPHS

  Yes

  No

  N/A

S040

• SLABS BEING LIFTED USING SLAB LIFTER?

  Yes

  No

  N/A

Q027

• TRENCH EXCAVATED TO CORRECT DEPTH?

  Yes

  No

  N/A

Q028

• BOX BUILT TO CORRECT SPECIFICATION?

  Yes

  No

  N/A

Q029

• TEMPORARY REINSTATEMENT TO CORRECT SPECIFICATION

  Yes

  No

  N/A

Q001

• PERMANENT REINSTATEMENT TO CORRECT SPECIFICATION

  Yes

  No

  N/A