Title Page

  • Completed by

  • Location
  • Conducted on

  • Job Reference number:

  • Is this work being carried out by a Contractor?

  • Name of Contractor

Organisation

  • Description of Works

  • Has a CDM Wizard / CPP assessment been completed

  • Has a Dynamic Risk Assessment / Method Statement been completed?

  • Is there an Emergency procedure available and are adequate first aid arrangements in place?

  • Are adequate welfare arrangements in place? Please give details:

  • Has adequate arrangements been made for the correct disposal of waste material?

  • Have all Operatives received a site induction?

  • Have all relevant persons / businesses potentially affected by the works been communicated with?

Site Safety

  • Is the site setup / layout suitable for the work and controlled to prevent in authorised access?

  • Are the correct signs / barriers being used to manage pedestrians and traffic?

  • Is the sites general housekeeping good with all equipment / materials / waste stored to prevent risks?

  • Can the site be secured appropriately to prevent access if the work is not completed today?

  • Have all services been identified and marked appropriately?

  • Sketch a brief layout of the site:

Personnel

  • Name of all operatives on site:

  • Are all operatives wearing the correct PPE as required by the risk assessments?

  • Is there evidence of safe lifting techniques / safe manual handling practices being carried out?<br>

  • Are all operatives adequately trained and are they demonstrating safe working methods for the work being carried out?

  • Are all operatives using plant / machinery / equipment competent and suitably qualified / certificated?

Tools / Equipment / Vehicles

  • Are the correct tools / equipment provided for the work being carried out?

  • List equipment being used on site:

  • Is all equipment in good repair with no damage or missing guards?

  • Is all equipment being used, serviced and calibrated as required?

  • Has a vehicle / trailer check been carried out for all vehicles / trailers?

  • Are all vehicles / trailers parked appropriately?

  • Are vehicles / trailers loaded and secured correctly?

Competed By

  • Completed By:

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