Title Page
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Area
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Conducted on
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Conducted by
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Location
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Pictures of site set up
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Vehicle registration
- BX15 USN
- ME19 UWH
- DV20 NLX
- DY20 LYV
- WN63 HDG
- MX70 VBN
- HL21 ZGK
- BT20 PZU
- HN71 GYK
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Staff involved ( List all staff on Site including site visitors )
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Project working on
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Gang working safely: pit safety, general NRSWA, site layout, WAH, PPE, gas test
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Vehicle legal: tyres legal, locks working and working beacon
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Vehicle exterior: clean and signed
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Pictures of vehicle exterior (front, sides and rear)
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Interior: cab and rear clean, organised, no rubbish and dash clear
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Pictures of interior (front cab, middle and tipper)
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Safety at Street Works book
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Constant gas monitor calibrated and working - battery ok
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Serial number
- KA421-1189858
- KA421-1189859
- KA421-1189808
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Cal expiry date
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Photo of gas monitors being used
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Quick cut saw with water suppression
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Whacker plate
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Power pack with breaker
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Slab lifter
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CAT and genny
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Cal expiry date
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Serial Number
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Core Drill
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T- Keys
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Pit lifter
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Correct signage and guarding equipment on vehicle<br>Cones x 12- check sleeves<br>Gate guards 3x4 sided<br>Road signs (L/R arrow, road narrows, MAW)<br>Pedestrian barriers, pedestrian arrow and apology board
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Pictures of damaged chapter 8 signage
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2KG Fire extinguisher
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PPE: Hard hat in date and ear defenders<br>Safety: glasses, gloves, boots (no steel showing), hi-visibility coat/vest, dust mask (FFP3), knee pads<br>Good condition stored correctly in blue bag - one kit per engineer
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Vehicle first aid kit available and fully stocked - with eye wash EXP 9-24
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Personnel appearance satisfactory
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Date of last van audit by manager
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Risk assessments completed correctly
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Job pack including STATS drawings, list of amenities, emergency numbers
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Comments
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Auditor Signature
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Operative Signature
