Title Page
-
Inspection Type: (Site Documents)
-
Contractor:
-
Team:
-
Date:
-
Prepared by:
-
Project Title:
-
ELR & Mileage:
-
Weather & temp:
Key summary and findings
Site documents
-
Work activities on site:
-
Work package plan?
-
SSOW: Mileage and date correct? Cards checked and all signed-in? Safe system suitable for work at site and access to site? Briefed to the team? How is the SSOW maintained? (photos)
-
SSOW pack suitable?
-
Task Brief: Mileage and date correct? All tasks on site contained within? Personnel, equipment, and plant correct? Emergency information correct? Signed and briefed? (photos)
-
Task brief suitable?
-
Work at Height Form? (ADB/DDD Projects)
-
Line Block Approval Form? (if applicable)
-
Risk Assessments: POWRA completed? Site specific hazards listed with appropriate mitigations? Correct date? Signed and briefed? (photos)
-
Risk assessments? (POWRA)
-
ALO form?
-
Daily/weekly work plan?
-
Tool & equipment check sheets?
-
Tool & plant service records?
-
Lift Plans? (if applicable)
-
HAVS forms?
-
Written Third party agreements?
-
Bird nesting form?
-
Ecology recommendations?
-
Operative competencies?
-
First aid competency?
-
LOLER certificates?
-
Additional comments?
Signature
Actions to be entered into CMO:
-
Enter an Action, an Action Owner, and an Action Date.
If N/A, enter “No actions”. -
1.
-
2.
-
3.
-
4.
-
5.
-
6.
-
7.
-
8.
-
All actions have been assigned correctly, and Close Calls recorded where required.