PAIR Form - Underfoot Conditions

• Inspection Type: (Underfoot Conditions)

• Contractor:

• Team:

• Date:

  Date

• Prepared by:

• Project Title:

• ELR & Mileage:
  Address

• Weather & temp:

Slips, Trips & Falls

• Work activities on site:

• Have personnel been briefed on potential site and work location hazards?

• Are staff wearing the correct safety footwear and is it fastened correctly?

• Has an approved point of access been utilised to gain entry to site?

• Is there a ‘safe or designated walking route’ from the access point to work location?

• Are people using the designated walking route?

• Are steps (permanent or mobile) being used when accessing via steep banks?

• Are walking and working areas free from overgrown vegetation and other obstacles that may restrict movement (E.g. has the site been prepped for safety)?

• Are catch pits and drainage lids visible and in place?

• Are any holes and underfoot hazards clearly marked or adequately protected?

• Is the work area organised and tidy?

• Is the work area reasonably level and free from slip and trip hazards?

• Has the work site got adequate lighting if the shift is in darkness?

• Are arrangements in place appropriate to the weather/seasonal conditions at site (E.g. is grit available for periods of ice)?

• Additional comments?

Actions to be entered into CMO:

• Enter an Action, an Action Owner, and an Action Date.
  If N/A, enter “No actions”.

• 1.

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• 3.

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• 6.

• 7.

• 8.

• All actions have been assigned correctly, and Close Calls recorded where required.

  Sign