Information

  • Document No.

  • Audit Title

  • Position

  • Prepared by

  • Conducted on

  • Client / DNO

  • Location

1.0 Vehicles and Staff

  • Vehicles present on site

  • Staff present on site

1.0 Site Observations

  • 1.1 Safe Access/Egress to work site?

  • 1.2 Appropriate warning signs posted?

  • 1.3 Are vehicles parked safely, are they secure and locked, are keys removed from ignition?

  • 1.4 Vehicles clean and tidy?

  • 1.5 Signing, lighting and guarding for street works present and correct? ( NRSWA).

  • 1.6 Pedestrian / Public safety satisfactory?

  • 1.7 Is livestock protected?

  • 1.8 Housekeeping - Safe and tidy site?

  • 1.9 Do all site operatives hold an in date SSE ID card?

2.0 Documentation

  • 2.1 Do all authorised staff have a physical copy of their authorisation?

  • 2.2 Do all authorised staff have a Distribution Safety Rule book?

  • 2.3 Has a site specific risk assessment been completed? are all staff signed onto the risk assessment?

  • 2.4 HSG47 Paperwork present and complete including utility plans?

  • 2.5 Polarity sheet completed in full and signed by 2 operatives?

  • 2.6 Are all safety documents understood? Take photograph of PTW, LWC, LOA.

  • 2.7 Latest toolbox talks signed off by all staff?

  • 2.8 Are safety docs PTW, LWC, LOA work instructions adequate and understood?

3.0 Plant, Tools & Equipment

  • 3.1 CAT Present?

  • CAT Number and calibration date photo:

  • 3.1.1 Genny Present?

  • Genny Number and calibration date photo:

  • 3.2 Are all other testing devices in full working order? Are they stored correctly in protective cases as issued? (Megger, Earth Loop, Volt Meter Test Lamps, Proving Unit, Rotoscope, KP Tester)

  • Test Equipment photo:

  • 3.3 Lifting equipment checked? LOLER colour tags all present? (Chains, shackles, strops, pull lifts, cum alongs etc)

  • 3.4 MEWP LOLER in date?

  • 3.5 MEWP vehicle check complete?

  • 3.6 Excavator LOLER in date?

  • 3.7 Excavator vehicle check complete?

  • 3.8 FASTRAC LOLER in date?

  • 3.9 FASTRAC vehicle check complete?

  • 3.10 HIAB/Lorry LOLER in date?

  • 3.11 HIAB/Lorry vehicle check complete?

  • 3.12 Trailer in good order - lights, number plate, break away cable etc?

  • 3.13 Wheel nut indicators on all vehicles?

  • 3.14 Are all tools in full working order? Check battery powered tools and chargers are fit for purpose.

  • 3.15 Are insulated rods in good condition and in date?

  • 3.16 Ladders tested, tagged, in date? Rungs, stiles, hooks, guides in good condition?

4.0 Electrical Safety

  • 4.1 PTW, LWC, or LOA instructions communicated and understood with everyone on site?

  • 4.2 Earths installed correctly and in date?

  • 4.3 Is work taking place in clear site of applied Earth?

  • 4.4 Are additional earths in use?

  • 4.6 Safe system of work as method statement?

  • 4.7 Has a Full CAT & Genny Survey been conducted & trial holes excavated? Services marked?

  • 4.8 If live working are live working procedures being followed?

  • 4.9 Appropriate warning, earths and notices applied

5.0 Welfare

  • 5.1 Are the site operatives working within 15 minutes of CDM yard?

  • 5.2 Provision for obtaining Hot Water?

  • 5.3 Suitable arrangements for toilets?

  • 5.4 Suitable facilities for washing available?

  • 5.5 Soap and towels / wipes available?

6.0 Personal Protective Equipment

  • 6.1 Are all site operatives compliant with the PPE policy? (Take photo of 5 points of PPE)

  • 6.2 Are all site operatives wearing issued eye protection only? (prescription eye protection accepted).

  • 6.3 Are all site operatives wearing issued ANSI 4 cut level gloves?

  • 6.4 Do all staff operatives have Hi-Vis waterproof clothing available?

  • 6.5 Are any staff live working?

  • 6.6 Are site operatives wearing live working PPE being worn as required?

  • 6.7 Insulated work gloves in date? (within 12 months from date of issue as written on PPE)

  • 6.8 Are Live working gloves stored in protective case?

  • 6.9 Live working helmet undamaged and fit for purpose including full face visor and worn when required?

  • 6.10 Live working helmet stored in protective case? (Must not be used for general wear).

  • 6.11 Is hearing protection, eye protection and respiratory protective equipment available for use with Stihl saw use?

  • 6.12 Have all site staff completed weekly climbing equipment check?

  • 6.13 Check climbing harnesses and associated equipment for defects.

  • 6.14 Pole top rescue kit placed at the base of the pole?

7.0 Environment

  • 7.1 Are appropriate sized spill kits readily available?

  • 7.2 Is waste correctly separated for disposal?

  • 7.4 COSHH containers marked and stored securely on vehicles/trailers?

  • 7.6 Confirm with site operatives that they can access COSHH register and safety data sheets on the Network app?

8.0 Safe Systems of Work

  • 8.1 Are exclusion zones set up as per working at height policy?

  • 8.2 Harness and fall restraint worn if working in MEWP?

  • Photo of MEWP restraint lanyard attached.

  • 8.3 MEWP / Lorry Loader stabilisers and spreaders pads in use?

  • 8.4 Helmet worn and chin strap engaged while working at height.

  • 8.5 No persons or plant machinery working below a person working at height?

  • 8.6 If using climbing gear are there 2 point soft attachment being used?

  • 8.7 No persons working under a suspended load?

9.0 Safety Equipment

  • 9.1 Is there a First aid kit present and is it complete?

  • 9.2 Is the an eye wash kit present and is it serviceable?

  • 9.3 Is there burns kit present and is it serviceable?

  • 9.4 Is there a serviceable fire extinguisher available? (check pressure and calibration)

Footer

  • Comments and Actions required:

  • Image of site.

  • FML / Auditor

  • Add signature

  • Team Leader

  • Add signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.