Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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1. (a) competence - do you have the necessary training/certification (NPTC / Lantra) to carry out the work?
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2 (a) Communication <br>have you informed all people who will be affected by your proposed work?
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2 (b) Communication<br>If lone working have you made arrangements for regular contact during your time on site?
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3 (a) risk control information <br>have you been briefed on the relevant risk assessment for the task/s to be performed?
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3 (b) risk control information <br>have you been briefed and do you have access to the relevant COSHH assessment where required?
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4 (a) Tools and Equipment<br>Have you carried out an inspection of the tools / equipment you will use and are they fit for purpose and in good repair?
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4 (b) Tools and Equipment<br>Where required, are calibration, conformity and / or test certificates valid
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5 (a) Work Area Condition<br>Do you have safe access to the area?
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5 (b) Work Area Condition<br>Are the site conditions safe for work to proceed?
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5 (c) Work Area Condition<br>Are current weather conditions satisfactory and unlikely to affect site safety and / or personal safety?
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6 (a) Work Area Protection <br>Are adequate barriers and hazard warning signs in place?
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7 (a) Emergencies<br>Do you know where the closest accident and emergency (A&E) department is?
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8 (a) Personal Protective Equipment (PPE) <br>Is your PPE appropriate and sufficient for the task?
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If you answered NO to any question DO NOT START WORK until you have consulted your Line Manager
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Put an X against any hazard listed below where you believe A hazard exists for the task you are carrying out or in the environment you are working.
Use the following table below to assess the risks -
HIGH - not adequately controlled - potential to cause fatal or major injury - Conact your Line Manager for further advice
MEDIUM - not adequately controlled - potential to lost time injury (over seven days) or long term health effects or significant property or environmental damage - Contact your Line Manager for further advice
LOW - only if you believe the risk is adequately controlled and the potential risk of injury is minimal -
HAZARDS
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Electricity /comms (eg. BT)
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Adverse weather
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Moving vehicles (e.g. on highway)
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Moving machinery (e.g. on-site)
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Confined spaces
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Uneven surfaces
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Use or exposure to gas
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Fire
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Noise
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Heat
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Violence / aggressive behaviour
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Slips or trips
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Steps / ladders
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Vibration
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Ventilation
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Mobile elevated work platforms
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Mobile crane
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dust or fumes
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Vermin (Weils disease)
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Manual handling
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Poor lighting
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Chemicals
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Access and Egress
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Syringes / Sharps
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Work near water
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Is anyone else at risk from your work e.g. Third Party / Others?
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Is there a Safe System of Work with controls in place?<br>NB: Any changes in the on-site conditions will require amendments to this assessment - please record them and brief your team accordingly.
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Names of all people briefed:
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Site Notes:
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Keep this document and send a copy to the office with job sheets
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Signature
