Information

  • MEMBER COMPANY ON SITE?

  • MEMBER COMPANY

  • SITE ADDRESS

  • SITE MANAGER/SUPERVISOR

  • SITE NUMBER

  • Prepared by

  • DATE/TIME

SITE SET UP

  • RATING

  • Perimeter Fencing/Signage

  • Traffic Management

  • Storage/Housekeeping

  • Other

WELFARE FACILITIES

  • RATING

  • Canteen

  • Hot/Warm Running Water

  • Hygeine/Soap/Towels etc

  • Toilets

  • Boiling Water/Heating Food

  • Other

DOCUMENTATION

  • RATING

  • Construction Phase Plan

  • Risk/COSHH Assessments/Method Statements

  • F10

  • H & S Law Poster

  • Insurance Certificate

  • Induction Records

  • Permits

  • Temporary Works Register

  • Other

WORK AT HEIGHT

  • RATING

  • Edge Protection

  • Ladders/Stepladders

  • Soft Landing Systems/Nets

  • Trestles

  • Harness/Lanyard

  • Stairwells/Openings in Floors

  • Low level access (podiums/hop ups)

  • Other

SCAFFOLD

  • RATING

  • Scaffold Access/ladders

  • Scaffold Suitability

  • Scaffold - General Condition

  • Scaffold Inspections/Handover Certificates

  • Scaffold Design

  • Scaffold Signage

  • Scaffold Ties/Stability

  • Scaffolders Competency

  • Other

MOBILE ACCESS TOWERS

  • RATING

  • Training/Competence

  • General Condition

  • Inspection/Tags

  • Other

OCCUPATIONAL HEALTH HAZARDS

  • RATING

  • Noise

  • Vibration

  • Asbestos/Asbestos Surveys

  • Lead

  • Dust

  • Other

LIFTING OPERATIONS

  • RATING

  • Lifting Plan

  • Certification

  • Inspections

  • Competency

  • Other

ELECTRICITY/PORTABLE TOOLS

  • RATING

  • Leads/Cables/Plugs

  • PAT Testing/Inspection

  • Other

PPE

  • RATING

  • Head

  • Eye

  • Hands

  • Respiratory Protective Equipment (RPE)

  • Hearing

  • Feet

  • Hi-viz

  • Other

FIRE/EMERGENCIES/FIRST AID

  • RATING

  • Fire Action Plan

  • Escape Routes/Signs

  • Fire Drill

  • Fire Extinguishers

  • First Aid

  • Accident Book

  • Other

EXCAVATIONS/EARTHWORKS

  • RATING

  • Underground/Overhead Services

  • Shoring/Battering/Benching

  • Edge Protection

  • Inspections

  • Confined Spaces

  • Other

ENVIRONMENTAL ISSUES

  • RATING

  • Transfer Notes/Licences

  • Contaminated ground/Water

  • Fuel Storage/Use

  • Spill Response/Containment/Emergencies

  • Other

MEWP'S

  • RATING

  • Operator Competence

  • Fall Prevention/Harnesses

  • Certification

  • Inspections

  • Barriers/Signage

  • Other

PLANT & EQUIPMENT

  • RATING

  • Operator Competence

  • Inspections

  • Maintenance/Certification

  • Safe Use

  • Quick Hitches

  • Other

SUBCONTRACTORS

  • RATING

  • Documentation

  • Competence

  • Housekeeping

  • Other

MANAGEMENT & SUPERVISION

  • RATING

  • Comments

FUTURE WORKS DISCUSSED

  • Are there proposed works at height, temporary works, excavations or other high risk activities proposed?

Sign off

  • I confirm I have had the contents of this report explained to me.

  • Member company Manager/Representative

  • Person conducting this inspection

  • In the event that a member is investigated by or on behalf of the Health and Safety Executive, Northern Counties Safety Group shall not be liable to the member for the Fees For Intervention paid by the member to the Health and Safety Executive in accordance with the Health and Safety (Fees) Regulations 2012.

CLOSE OUT

  • Corrective Actions Carried Out:

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