PACE ELECTRICAL SERVICES LIMITED

• Document No.

• Audit Title

• Client / Site

CLIENT/SITE/JOB INFORMATION

• Client Name:

• Job number:

• Overview of job:

SIGNIFICANT HAZARDS

• Work at height

  Yes

  No

  N/A

• Working from ladder

  Yes

  No

  N/A

• Working from scaffold

  Yes

  No

  N/A

• Working from EWP

  Yes

  No

  N/A

• Electricity

  Yes

  No

  N/A

• Confined space

  Yes

  No

  N/A

• Overhead hazard

  Yes

  No

  N/A

• Underfoot hazard

  Yes

  No

  N/A

• Heavy/awkward lifting

  Yes

  No

  N/A

• Noise

  Yes

  No

  N/A

• Excavations

  Yes

  No

  N/A

• Floor openings

  Yes

  No

  N/A

• Poor housekeeping

  Yes

  No

  N/A

• Dust/fumes

  Yes

  No

  N/A

• Other trades/members of the public

  Yes

  No

  N/A

• Over head power lines

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

PERSONAL PROTECTIVE EQUIPMENT

• Eye protection

  Yes

  No

  N/A

• Hearing protection

  Yes

  No

  N/A

• Hi-visibility vest/clothing

  Yes

  No

  N/A

• Hard hat

  Yes

  No

  N/A

• Safety footwear

  Yes

  No

  N/A

• Isolation lock/tag

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

CONTROLS IN PLACE

• Fall protection in place

  Yes

  No

  N/A

• Ladders safe and secured

  Yes

  No

  N/A

• Scaffold tagged and secure

  Yes

  No

  N/A

• EWP maintained/checked/fit for purpose

  Yes

  No

  N/A

• Electrical supply isolated/locked/tagged

  Yes

  No

  N/A

• Electrical safety device (RCD)

  Yes

  No

  N/A

• Portable electrical equipment tested/tagged

  Yes

  No

  N/A

• Clear/safe underfoot

  Yes

  No

  N/A

• Clear/safe underfoot

  Yes

  No

  N/A

• Floor openings covered

  Yes

  No

  N/A

• Excavations identified/covered

  Safe

  At Risk

  N/A

• Protection from overhead hazards

  Yes

  No

  N/A

• Signs/cones/barriers

  Yes

  No

  N/A

• Overhead lines made safe/shrouded

  Yes

  No

  N/A

• Material safety data sheets on site

  Yes

  No

  N/A

• Fire extinguisher available

  Yes

  No

  N/A

• First aid kit availiable

  Yes

  No

  N/A

• Special instructions delivered/received

Your sub contractos

• Are sub contractors being used (List)

  Yes

  No

  N/A

• Is their SSSP on site

  Yes

  No

  N/A

• Working safely

  Yes

  No

  N/A

• PPE being worn

  Yes

  No

  N/A

ASSESSED BY

• Assessor,

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• Briefed contractors list:

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