Title Page

  • Location

  • Conducted on

  • Audited by signature

  • Location
  • Team Leader signature

  • Second Man

  • Vehicle Registration

Pre Start Checks

Pre Start Site Specific Safety Briefing

  • Is the vehicle tidy? All kit, fittings, and pipes stored correctly?

  • Nearest hospital location known?

  • What3words?

  • What3words made known to workers?

  • Brief of works to be undertaken explained?

  • Brief of conditions that will be worked in and expected throughout?

  • Location of first aid kit and eye wash made known to workers?

  • Location of spill kit made known to workers?

  • Are the spill kits an appropriate size for the task?

  • Fueling point selected away from drains or watercourses?

  • Diesel / Oil / Fuels tagged and safely stored in drip trays?

Documentation

  • Individual ID cards on-site and available?

  • Risk Assessment for the location sufficient?

  • Are all Training Certificates / ID Cards on-site and in date?

  • Are all safety documents / work instructions adequate and understood?

  • Fuel Card?

Plant and Equipment

  • CAT working and calibrated?

  • CAT expiry date:

  • Genny working and calibrated?

  • Genny expiry date:

  • Fire Extinguisher visual check performed?

  • Fire Extinguisher expiry date:

  • Excavator in good working order and fit for purpose - checks performed?

  • Trailer in good working order and fit for purpose - checks performed?

  • All general and insulated hand tools in good working order?

  • Plant and tools in good condition with no significant damage?

  • Stihl Saw - In good working order - visual pre-checks performed, guards in place?

  • Stihl Saw - Service date

  • Trash Pump - In good working order - visual pre-checks performed, guards in place?

  • Trash Pump - Service date

  • 110V Generator - In good working order - visual pre-checks performed?

  • 110V Generator - Service date

  • Blow torch available and in good working order?

Personal Protective Equipment

  • Flame Retardent Overalls in good condition and being worn?

  • Safety footwear in good condition and being worn?

  • Hearing protection available and being worn when required?

  • Head protection available and being worn when required?

  • Gloves appropriate of the task available and worn when required?

  • Eye protection available and being worn when required?

  • Dust masks available and being worn when required?

  • Is all PPE correctly stored?

  • Sink / Bowl for eye washing available? Or antibacterial wipes / gel?

  • First aid kit available?

  • First aid kit expiry date:

  • Eye wash station available?

  • Eye wash expiry date:

Environmental Awareness

  • Stockpiled spoil is away from drains and watercourses?

  • Stockpiled spoil does not exceed 50m³ in volume?

  • Filter sock available and used where required?

  • Team leader knows how to identify invasive plants that may affect pipeworks - Japanese Knotweed, Himalayan Balsam etc.?

  • All tools, equipment, and detritus removed from the location on completion of works?

  • A final visual check conducted by the team leader for any refuse left behind?

Water Quality

  • Chlorine spray (fully labelled) available?

  • Chlorine tablets available if required?

  • Standpipe available for flushing with non return valve?

  • Standpipe kept clean and in a protective bag when not in use?

  • Sample bottles available and within date?

  • Chlorine comparator, tablets, tubes and crusher available?

Comments, Actions Required or Observations

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Audited by

  • Report Completed by

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