Lorry AUDIT 29/07/14

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Vehicle Check

• Vehicle Tax In Date

• Working + Clean Roof Mounted Beacons

• Chevrons On Rear Of Vehicle

• Overall condition of vehicle

Water Filling

• Please enter hydrant reading from standpipe

• Length of hydrant filling hose

Health & Safety Risk Assessment + Method Statement

• Method Statement & Risk Assessment Signed?

  Yes

  No

  N/A

• Generic Risk Assessment & Method Statement held on lorry

  Yes

  No

  N/A

• Site specific Risk Assessment & Method Statement on Lorry?

  Yes

  No

  N/A

• Site File containing Training Certificates and Local Emergency Locations?

  Yes

  No

  N/A

PPE

• Hard Hat

• Hi Visibility Clothing Must Be Long Sleeved

• Hi Vis Trousers for Night Works

• Ear Defenders

• Eye Protection

• Suitable Gloves for Relevant Works

• Face visor for jetting works

Signing Lighting & Guarding - Chapter 8

• 2 Men at works signs

  Yes

  No

  N/A

• 2 Arrow signs

  Yes

  No

  N/A

• 2 road narrow signs

  Yes

  No

  N/A

• 12 Cones (750mm)

  Yes

  No

  N/A

• Four way Barrier System

  Yes

  No

  N/A

• Chapter 8 Book (small red book) or paper copy in site pack

  Yes

  No

  N/A

Ancillary Equipment

• Standard Man Hole Keys

  Yes

  No

  N/A

• Small Manhole Keys (S24)

  Yes

  No

  N/A

• 5 Foot Wrecking Bar

  Yes

  No

  N/A

• Crow Bar

  Yes

  No

  N/A

• Screwdriver Set

  Yes

  No

  N/A

• Chisel Set

  Yes

  No

  N/A

• Club Hammer

  Yes

  No

  N/A

• Sledge Hammer

  Yes

  No

  N/A

• Socket Set

  Yes

  No

  N/A

• Adjustable spanners

  Yes

  No

  N/A

• Equipment clean and being stored in a safe secure location?

• Add media

  Media

Safety Equipment

• Gas Monitor & Charger?

  Yes

  No

  N/A

• Harness?

  Yes

  No

  N/A

• Fall Arrest System?

  Yes

  No

  N/A

• Escape set?

  Yes

  No

  N/A

• Safety Equipment clean and being stored in a safe secure location?

Jetting Equipment

• Small jetting bombs

  Yes

  No

  N/A

• Medium jetting bombs

  Yes

  No

  N/A

• Large jetting bomb

  Yes

  No

  N/A

• Sledge bomb

  Yes

  No

  N/A

• Tiger tail, jetting guide

  Yes

  No

  N/A

• 4" suction pipe

• 6" suction pipe

• Drain Rods

  Yes

  No

  N/A

Miscellaneous

• Spill kit?

• First Aid Kit In Easy To Find Location

  Yes

  No

  N/A

• Eye Wash?

• Fire Extinguisher, In Date + Unused

  Yes

  No

  N/A

• Hand Washing Facility's With Hot Running Water?

Training certification

• Confined Space Trained

• High pressure jetting

• Street Works

• Cscs card

Questions For Operator

• Please Explain Your Emergency Proceedure.

  Safe

  At Risk

  N/A

Comments

• Notes from Operators

• Site Confidence rating.

• Add signature

  Sign