MDG-TSG-LP-012.12-PPE

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Transmission Services Gas
  
  UK MDG Transmission Services Gas
  
  Project Health and Safety Inspection Checklist
  

• To be completed by Project Supervisor or Nominated person weekly from the start of construction work on site. Completed forms are to be kept readily available (preferably on site) for the duration of construction works, after which time shall form part of the CDM Health & Safety file.
  

• Contract No:

• Project Title:

• Week No.

• Date

  Date

• 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.
  

• S = Satisfactory, U = Unsatisfactory, O = Observation, NA = Not Applicable

• Has adequate personal protective equipment, e.g. hard hats, safety boots, gloves, eye protection and respiratory equipment been provided in accordance with the Safety Line Policy?

  S

  U

  O

  NA

• Are adequate supplies of PPE held in stores, including any special items that may be required in an emergency, or which will form part of a requirement of a COSHH assessment?

  S

  U

  O

  NA

• PPE Compliance Check

• No. of Checks

• No. of Compliance

• % of Compliance (i)/(ii)

• Remarks:

• Please mark Yes or No to the following questions

Person 1

• Head Protection

  Yes

  No

• Light Eye Protection

  Yes

  No

• Hearing Protection

  Yes

  No

• Overalls or Coveralls

  Yes

  No

• High Visibility Jacket

  Yes

  No

• Gloves

  Yes

  No

• Safety boots

  Yes

  No

Person 2

• Head Protection

  Yes

  No

• Light Eye Protection

  Yes

  No

• Hearing Protection

  Yes

  No

• Overalls or Coveralls

  Yes

  No

• High Visibility Jacket

  Yes

  No

• Gloves

  Yes

  No

• Safety boots

  Yes

  No

Person 3

• Head Protection

  Yes

  No

• Light Eye Protection

  Yes

  No

• Hearing Protection

  Yes

  No

• Overalls or Coveralls

  Yes

  No

• High Visibility Jacket

  Yes

  No

• Gloves

  Yes

  No

• Safety boots

  Yes

  No

Person 4

• Head Protection

  Yes

  No

• Light Eye Protection

  Yes

  No

• Hearing Protection

  Yes

  No

• Overalls or Coveralls

  Yes

  No

• High Visibility Jacket

  Yes

  No

• Gloves

  Yes

  No

• Safety boots

  Yes

  No

Person 5

• Head Protection

  Yes

  No

• Light Eye Protection

  Yes

  No

• Hearing Protection

  Yes

  No

• Overalls or Coveralls

  Yes

  No

• High Visibility Jacket

  Yes

  No

• Gloves

  Yes

  No

• Safety boots

  Yes

  No

• Please mark Yes or No to the following questions

Person 6

• Head Protection

  Yes

  No

• Light Eye Protection

  Yes

  No

• Hearing Protection

  Yes

  No

• Overalls or Coveralls

  Yes

  No

• High Visibility Jacket

  Yes

  No

• Gloves

  Yes

  No

• Safety boots

  Yes

  No

Person 7

• Head Protection

  Yes

  No

• Light Eye Protection

  Yes

  No

• Hearing Protection

  Yes

  No

• Overalls or Coveralls

  Yes

  No

• High Visibility Jacket

  Yes

  No

• Gloves

  Yes

  No

• Safety boots

  Yes

  No

Person 8

• Head Protection

  Yes

  No

• Light Eye Protection

  Yes

  No

• Hearing Protection

  Yes

  No

• Overalls or Coveralls

  Yes

  No

• High Visibility Jacket

  Yes

  No

• Gloves

  Yes

  No

• Safety boots

  Yes

  No

Person 9

• Head Protection

  Yes

  No

• Light Eye Protection

  Yes

  No

• Hearing Protection

  Yes

  No

• Overalls or Coveralls

  Yes

  No

• High Visibility Jacket

  Yes

  No

• Gloves

  Yes

  No

• Safety boots

  Yes

  No

Person 10

• Head Protection

  Yes

  No

• Light Eye Protection

  Yes

  No

• Hearing Protection

  Yes

  No

• Overalls or Coveralls

  Yes

  No

• High Visibility Jacket

  Yes

  No

• Gloves

  Yes

  No

• Safety boots

  Yes

  No

• Has any of the PPE (see above risk been risked out?)

  Yes

  No
3f206182-e4f6-11e1-aff1-0800200c9a66;0

• Evidence – Risk Assessment No

• Other

• Name of competent person

• Designation

• Is the equipment in good condition and worn by all who need it, e.g. no hard hats painted or holes drilled into them?

  Yes

  No

• Are PPE signs posted in areas where a special requirement is needed?

  Yes

  No

• Is there a system in place to change worn out or damaged PPE etc.?

  Yes

  No

• Are employees aware that helmets have a life-span and will require changing periodically?

  Yes

  No

• Is appropriate storage for PPE available?

  Yes

  No

• Auditor's Signature

  Sign

• Project Manager's Signature

  Sign

• Date

  Date