Section: 3. Team Details & Qualifications.

Section: 3. Team Details & Qualifications.

Team Leader:

Mate 1:

Mate 2:

Qualification - Team Leader:

3.1 ID Cards

3.2 Safety Passport

3.3 NRSWA Valid Card

3.4 CSCS or EUSR (Energy & Utility Skills Register) Water, Gas, Power & Waste

3.5 CPCS or Plant & Equipment Card

Qualification - Mate 1:

3.1 ID Cards

3.2 Safety Passport

3.3 NRSWA Valid Card

3.4 CSCS or EUSR (Energy & Utility Skills Register) Water, Gas, Power & Waste

3.5 CPCS or Plant & Equipment Card

Qualification - Mate 2:

3.1 ID Cards

3.2 Safety Passport

3.3 NRSWA Valid Card

3.4 CSCS or EUSR (Energy & Utility Skills Register) Water, Gas, Power & Waste

3.5 CPCS or Plant & Equipment Card

Section: 4. Fire Safety & Rescue.

First Aid, Health & Welfare Facilities

4.1 First Aid (Trained Person)

4.2 First Aid Kit Carried (Correct Size)

4.3 Eye Wash Carried (In Date)

4.4 Clean Water Carried

4.5 Liquid Soap/Hand Wipes Available

4.6 Fire Extinguisher Available (In date)

4.7 Spill Kit Available and Adequate Stock Contained

4.8 Absorbent Granules Available

Section: 5. Personal Protective Equipment (PPE)

Personal Protective Equipment (PPE)

5.1 Hard Hat

5.1 Is item suitable for use?

5.2 Ear Defenders

5.2 Is item suitable for use?

5.3 Safety Specs & Goggles

5.3 Is item suitable for use?

5.4 Boots (Steel toe capped foot wear, suitable ankle support)

5.4 Is item suitable for use?

5.5 Hi-Visibility Clothing (Long Sleeve Vest/Jerkin)

5.5 Is item suitable for use?

5.6 Gloves (Anti-puncture)

5.6 Is item suitable for use?

5.7 Dust Mask

5.7 Is item suitable for use?

5.8 Uniform (Company Corporate Issue)

5.8 Is item suitable for use?

5.9 Fire Retardant or Probane Overalls/Clothing

5.9 Is item suitable for use?

Section: 6. Documentation & Compliance

Section: 6. Documentation & Compliance.

6.1 Gang Pack Present & Complete

6.2. NRSWA - Red Book - Safety At Street Works and Road Works a Code of Practice

6.3 Method Statements Appropriate to Work Undertake (Generic/Specific)

6.3.1 Method Statement Type

6.4 Risk Assessments Appropriate for Tasks being Undertaken

6.4.1 Risk Assessment Type

6.5 Site Specific Risk Assessment reviewed and signed

6.5.1 Risk Assessment updated to reflect changes in tasks/conditions

6.6 Site/Work Instruction Available

6.6.1 Is the work instruction clear and understandable

6.6.2 Does the Team/Operative understand the work instruction

6.7 COSHH Assessment Available

6.7.1 COSHH Assessment relevant for tasks/activities being undertaken

6.8 Containers labelled with contents

6.9 Operatives Understanding of above documentation

6.10 Daily driver records completed correctly (Where applicable)

6.11 Daily driver check & defect book completed (Where applicable)

Section: 7. Site Set up & Safety

Section: 7. Site Set up & Safety

NRSWA & Housekeeping

7.1 Sign Lighting & Guarding in accordance with NRSWA

7.1.1 NRSWA Set Out in Correct Sequence

7.2 Excavation Guarded

7.3 Courtesy Sign Displayed

7.3.1 The Courtesy Sign Displayed is

7.3.2 Where required is a Permit Board clearly Displayed

7.3.2.1 Is the correct permit number and notice end date clearly displayed

7.4 Clear defined Pedestrian Access

7.5 Footpath Boards & Barriers Secure

7.6 Has the trench been excavated to the correct dimension (size & depth)

7.6.1 Does the trench have adequate clearance (does it conform to the correct dimension)

7.7 is the safe

7.7.1 Is the site clean & tidy

7.8 Is Safe Access to Properties Maintained

7.9 Is Spoil & Materials within Barriers

7.10 Trailing Hoses within Barriers

7.11 Are Storage Areas Guarded

7.11.1 Are Welfare Areas Guarded

7.12 Is the condition of all Hand Tools acceptable

Section: 8. Vehicle & Plant

Section: 8. Vehicle & Plant

8.1 Vehicle Tidiness, Outside (Cab & Body)

8.1 Vehicle Tidiness, Inside (Cab)

8.2 Flashing Beacons Operation

8.3 Plant Operator(s) Trained

8.3.1 Excavator

8.3.2 Dumper

8.3.3 Winch

8.3.4 Lorry Loader

8.4 Plant condition acceptable

8.4.1 Excavator

8.4.1.1 Excavator trailer

8.4.2 Breaker & Buckets

8.4.3 Roller Breaker

8.4.4 Roller trailer

8.4.5 Compressor

8.4.6 Breaker

8.4.6.1 Cutter / Blade

8.4.6.2 Hose condition

8.4.7 Trench Rammer / Wacker

8.4.8 Vibrating Plate (Wacker)

8.4.9 Disc Cutter (Stihl Saw)

8.4.9.1 Diamond Blade

8.4.10 Cobra Breaker / Breaker Pack

8.4.11 Cable Avoidance Tool (CAT) & Genny (calibration in date)

8.4.12 Clegg (calibration in date)

Section: 9. Signatures

Section: 9. Signature

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Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.