Title Page

  • Completed forms are to be kept readily available (preferably on site) for the duration of construction works, after which time shall from part of the CDM Health & Safety file.

  • Sensible Monitoring Audit Completed By:

  • Site Manager:

  • Contract Number:

  • Project Title:

  • Conducted on

General

  • Any H&S actions identified shall be entered onto Audit / Inspection Action Log and brought to the urgent attention of the appropriate personnel as soon as possible. Contractor / Project Manager to be notified of actions required / taken.

  • 1) Is there a Method Statement / Risk Assessment / Permit to Work available on site for the activity?<br>a) Has it been briefed out and signed for?

  • Comments:

  • Attach any images relevant to question 1 here.

  • 2) Are the Emergency Procedures available on site?<br>a) Are all operatives aware of them?

  • Comments:

  • Attach any images relevant to question 2 here.

  • 3) Have all operatives been inducted to the Project and received E & US training?

  • Comments:

  • Attach any images relevant to question 3 here.

  • 4) Are the welfare facilities adequate and is there appropriate first aid provision on site? <br>(Numbers of Appointed Persons / First Aiders, Locations / Contents of Kit)

  • Comments:

  • Attach any images relevant to question 4 here.

  • 5) Is the correct PPE for the task being worn?<br>(Check condition, age, storage, training)

  • Comments:

  • Attach any images relevant to question 5 here.

  • 6) Is the site tidy and free from trip hazards and is there safe access and egress available for all?

  • Comments:

  • Attach any images relevant to question 6 here.

  • 7) Are all operatives competent to perform the task?<br>(Check CITB, CSCS Card, Training Records etc.)

  • Comments:

  • Attach any images relevant to question 7 here.

  • 8) What liaison with third parties have taken place?

  • Comments:

  • Attach any images relevant to question 8 here.

  • 9) Have all services been identified, located and proven?<br>(C.A.T., Plans, trial holes, ground penetrating radar)

  • Comments:

  • Attach any images relevant to question 9 here.

  • 10) Have foreign services been identified, located and marked up?<br>(Plans available including depth)

  • Comments:

  • Attach any images relevant to question 10 here.

  • 11) Is there more than one marker post used so that the direction of the service is obvious?

  • Comments:

  • Attach any images relevant to question 11 here.

  • 12) Was a C.A.T used before and during the excavation?

  • Comments:

  • Attach any images relevant to question 12 here.

  • 13) Have overhead warning signs and poles been erected near electrical cables?

  • Comments:

  • Attach any images relevant to question 13 here.

  • 14) Has any topsoil been placed below overheads?

  • Comments:

  • Attach any images relevant to question 14 here.

  • 15) Have all exposed services been adequately supported / protected?<br>(Not used as hand / footholds)

  • Comments:

  • Attach any images relevant to question 15 here.

  • 16) Is it clear to all involved when hand-digging must be undertaken and mechanical means must not be used?

  • Comments:

  • Attach any images relevant to question 16 here.

  • 17) Have the excavation been designed ?<br>(Consider hole, access for vehicles, position of plant and spoil)

  • Comments:

  • Attach any images relevant to question 17 here.

  • 18) Is the excavation likely to affect any neighbouring structures?

  • Comments:

  • Attach any images relevant to question 18 here.

  • 19) Are / were banksmen used for the excavators?

  • Comments:

  • Attach any images relevant to question 19 here.

  • 20) Is the excavation adequately signed and guarded?

  • Comments:

  • Attach any images relevant to question 20 here.

  • 21) Is the excavation adequately supported / battered back in a safe condition?

  • Comments:

  • Attach any images relevant to question 21 here.

  • 22) If supported, has an F91 inspection been carried out satisfactorily for the excavation?

  • Comments:

  • Attach any images relevant to question 22 here.

  • 23) Is the excavated material positioned at a sufficient distance from the excavation?

  • Comments:

  • Attach any images relevant to question 23 here.

  • 24) Are any ladders that are in use adequate?<br>(Length, Condition, Tied, Footed, Angle)

  • Comments:

  • Attach any images relevant to question 24 here.

  • 25) Are any items on the trench side likely to fall in the hole?

  • Comments:

  • Attach any images relevant to question 25 here.

  • 26) Is the excavation free from water?<br>a) Are the pumps discharging a sufficient distance from the excavation, is a permit in place?

  • Comments:

  • Attach any images relevant to question 26 here.

  • 27) Is atmospheric monitoring in place?<br>(Calibration, Risk Assessment, Competency of Users)

  • Comments:

  • Attach any images relevant to question 27 here.

  • 28) Do all items of plant on site have the appropriate supporting documentation?<br>(Certificates, Inspections)

  • Comments:

  • Attach any images relevant to question 28 here.

  • 29) Is there safe access to the site?<br>e.g. To and from road, across farm land etc.

  • Comments:

  • Attach any images relevant to question 29 here.

Sign Off Audit

  • Print Name:

  • Signature:

  • Project Manager Name:

  • Signature:

  • Designation:

  • Select date

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