Information

  • Site name

  • Project title and reference

  • Principal Contractor

  • Veolia Project Manager

  • Date and time

  • Inspectors name

  • Inspectors position

Documentation

  • Form F10 completed, on display and in date

  • Insurance on display and valid

  • Emergency procedure, phone numbers and plan present

  • Fire Safety plan prepared

  • Traffic Management plan on display, up to date

  • File for site safety audits, audits completed

  • Signing in book, all signed in and out

  • Induction procedure, all on site received inductions

  • Site diary, entries up to date

  • Accident book, records complete

  • Near miss reporting procedure, any recorded

  • Lifting equipment / plant certification present

  • Excavation register completed, permits in place

  • Construction Phase Plan present and up to date

  • Risk assessments compiled and signed off for relevant tasks

  • Method Statements prepared and signed off for relevant tasks

  • Company Health and Safety policy, signed and in date

  • HSE law poster, details completed

Signs

Notices to depot personnel / visitors / public

  • Closed

  • No unauthorised entry

  • All visitors must report to site office - with directions

  • Site office

  • CDM / Site area

Specific hazard warnings

  • Overhead working

  • Danger of death - live electrics

  • Danger - mobile plant / vehicles

  • Danger demolition in progress

  • Hard hat site / area

  • Protective footwear must be worn

  • Hi viz clothing to be worn

Safe conditions

  • Fire exit routes marked

  • Fire exit - keep clear

  • Muster point marked

Health and Safety equipment

  • Fire extinguishers - sufficient, correct type, in date

  • First aid kits, eye wash, adequately stocked

  • Personal gas monitors present / being worn

  • Lights, safe task lighting and warning lights

Spare PPE for visitors

  • Hard hats

  • Protective glasses / goggles

  • Dust masks

  • Hi viz vests / coats

  • Protective gloves

Welfare

  • Washroom and toilets

  • Barrier creams and soap

  • Hand towels / drier

  • Mess room

  • Site office

Site works

  • Works compliant with method statements and risk assessments

  • Fixed scaffolding

  • Mobile towers - safely used

  • Mobile platforms - safe operation

  • Ladders and steps used correctly

  • Other work at height controlled

  • Hoarding / fencing - secure, safe

  • Trip hazards

  • Construction debris - cleaned, correct disposal

  • Storage areas - correctly set up, safe storage

  • Access / egress routes - marked, kept clear

  • Tools - 110v only

  • Temporary power supply - 110v only

  • Tools and equipment safe / in good condition

  • Site plant operated safely

  • Fuel / refuelling controlled

  • Plant safety equipment - beacons, sounders, bars, etc

  • Gas works safe

Action plan

Item 1

  • Item of concern

  • Action already taken

  • Further action considered necessary

Item 2

  • Item of concern

  • Action already taken

  • Further action considered necessary

Item 3

  • Item of concern

  • Action already taken

  • Further action considered necessary

Item 4

  • Item of concern

  • Action already taken

  • Further action considered necessary

Item 5

  • Item of concern

  • Action already taken

  • Further action considered necessary

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.