PMD On-site Inspection

• Document No.

• Title

• Area Office

• Date

  Date

• Conducted by

• Location
  Address

• Operative

• Health & Safety Inspection

  PfP Employee

  Contractor

  PfP Gas Operative

Documentation

• Health & Safety manual available?

  Yes

  No

• COSHH Assessments available & chemicals labelled?

  Satisfactory

  Unsatisfactory

• Task specific & dynamic risk assessments available?

  Yes

  No

Operative Appearance PPE & Work Wear

• Issued uniform being worn?

  Yes

  No

• Identification badge visible?

  Yes

  No

• Does the operative have a valid Gas Safe card?

  Yes

  No

  N/A

• Uniform condition?

  Satisfactory

  Unsatisfactory

• Appropriate PPE being worn and serviceable?

  Yes

  No

  N/A

Tools, Equipment & Materials

• Hand tools in a serviceable condition?<br>If not inform tradesman not to use and replace and record

  Safe

  At Risk

  N/A

• PAT test date?

  Date

• Are Power Tools electrical leads including RCD in a serviceable condition?

  Safe

  At Risk

  N/A

• Flue Gas Analyser calibration in date?

  Yes

  No

  N/A

• Does the operative have Tightness testing / Soundness testing / Purging equipment?

  Yes

  No

  N/A

• Does the operative have temporary continuity bonds?

  Yes

  No

  N/A

• Does the operative have smoke emitters e.g. Smoke matches / pellets?

  Yes

  No

  N/A

• Does the operative have L.D.F and/or electronic detection?

  Yes

  No

  N/A

• Does the operative have electrical test equipment for ‘Safe isolation’ and ‘safe to touch’?

  Yes

  No

  N/A

• Does the operative carry appropriate fittings to ‘isolate’ appliances and /or meters / pipework eg plugs and caps?

  Yes

  No

  N/A

• Does the operative replenish essential tools and consumable items?

  Yes

  No

  N/A

Safe working at height

• All working at height equipment company issue & Registered with unique PfP serial number & accessories?

  Safe

  At Risk

  N/A

• How is the working at height being carried out?

  Safe

  At Risk

  N/A

• Ladder inspection form completed and up to date?

  Yes

  No

  N/A

• In use Scaffolding tag completed and attached?

  Yes

  No

  N/A

Work area housekeeping including occupied premises

• Have the risks & controls been explained to the customer?

  Yes

  No

  N/A

• Gas, Electricity & Water isolated?

  Safe

  At Risk

  N/A

• Is the work area segregated or cordoned off?

  Safe

  At Risk

  N/A

• Access & exit routes free from obstructions?<br>Check that external doors can be closed

  Safe

  At Risk

  N/A

• Is the area free from slip, trip or fall hazards?

  Safe

  At Risk

  N/A

• Have any tools and equipment been left unattended?

  Safe

  At Risk

  N/A

• Is there floor and worktop protection in use?

  Yes

  No

  N/A

Documentation

• COSHH Assessments available & chemicals labelled?

  Yes

  No

  N/A

• Health & Safety manual available?

  Yes

  No

• Task specific & dynamic risk assessments available?

  Yes

  No

• Is there a task related Method Statement available?

  Yes

  No

  N/A

• Does the contractor have trade related Identity Card,<br>EG Gas Safe, Scaffolder?

  Yes

  No

  N/A

• Is the contractors work being carried out by a sub-contractor? Name of sub-contractor

Contractor Appearance PPE & Work Wear

• Identification badge visible?

  Yes

  No

• Work wear appearance?

  Satisfactory

  Unsatisfactory

• Appropriate PPE being worn and serviceable?

  Yes

  No

  N/A

Tools & Equipment

• Hand tools in a serviceable condition?<br>If not inform tradesman not to use and replace and record

  Safe

  At Risk

  N/A

• Are Power Tools 110v and RCD protected and appear to be in a serviceable condition?

  Safe

  At Risk

  N/A

• Evidence of electrical equipment PAT tested?

  Yes

  No

  N/A

• Electrical isolation & Testing equipment available?

  Safe

  At Risk

  N/A

Safe working at height

• All working at height equipment EN 131 class 2 with SWL 150kg?

  Yes

  No

  N/A

• How is the working at height being carried out?

  Safe

  At Risk

  N/A

• Weekly ladder inspection record completed and up to date?

  Yes

  No

  N/A

• In use Scaffolding Tag completed and attached?

  Yes

  No

  N/A

Work area housekeeping including occupied premises

• Have the risks & controls been explained to the customer?

  Yes

  No

  N/A

• Gas, Electricity & Water isolated?

  Safe

  At Risk

  N/A

• Have any tools and equipment been left unattended?

  Safe

  At Risk

  N/A

• Is the area free from slip, trip or fall hazards?

  Safe

  At Risk

  N/A

• Is there floor and worktop protection in use?

  Yes

  No

  N/A

• Is the work area segregated or cordoned off?

  Safe

  At Risk

  N/A

• Access & exit routes free from obstructions, waste & materials?

  Safe

  At Risk

  N/A

Documentation

• Health & Safety manual available?

  Yes

  No

• Task specific & dynamic risk assessments available?

  Yes

  No

• COSHH Assessments available & chemicals labelled?

  Yes

  No

  N/A

Operative Appearance PPE & Work Wear

• Issued uniform being worn?

  Yes

  No

• Identification badge visible?

  Yes

  No

• Uniform condition?

  Satisfactory

  Unsatisfactory

• Appropriate PPE being worn and serviceable?

  Yes

  No

  N/A

Tools & Equipment

• Hand tools in a serviceable condition?<br>If not inform tradesman not to use and replace and record

  Safe

  At Risk

  N/A

• Are Power Tools electrical leads including RCD in a serviceable condition?

  Safe

  At Risk

  N/A

• PAT test date?

  Date

• Calibrated equipment in date?

  Yes

  No

  N/A

• Electrical isolation & Testing equipment available?

  Safe

  At Risk

  N/A

Safe working at height

• All working at height equipment company issue & Registered with unique PfP serial number & accessories?

  Safe

  At Risk

  N/A

• How is the working at height being carried out?

  Safe

  At Risk

  N/A

• Ladder inspection form completed and up to date?

  Yes

  No

  N/A

• In use Scaffolding tag completed and attached?

  Yes

  No

  N/A

Work area housekeeping including occupied premises

• Have the risks & controls been explained to the customer?

  Yes

  No

  N/A

• Gas, Electricity & Water isolated?

  Safe

  At Risk

  N/A

• Is the work area segregated or cordoned off?

  Safe

  At Risk

  N/A

• Access & exit routes free from obstructions?<br>Check that external doors can be closed

  Safe

  At Risk

  N/A

• Is the area free from slip, trip or fall hazards?

  Safe

  At Risk

  N/A

• Have any tools and equipment been left unattended?

  Safe

  At Risk

  N/A

• Is there floor and worktop protection in use?

  Yes

  No

  N/A

• Vehicle Inspection (PfP employees only)

Vehicle Description

• Make & Model

  Ford Connect

  Ford Transit

  Ford Fiesta

  Rental

• Registration

• Mileage

Engine Compartment

• Engine compartment fluids at correct levels?

  Satisfactory

  Unsatisfactory

Exterior Body and Glass (Take Photos of any noted damage)

• Front lights & indicators?

  Safe

  At Risk

  N/A

• Windscreen Free of Cracks and Chips?

  Yes

  No

  N/A

• Bonnet, Grill and Bumper Free of Damage?

  Yes

  No

  N/A

• Front Tyres in Good Repair with no Visible Signs of Wear or Cracking in Sidewall?

  Safe

  At Risk

  N/A

• Left Side Free of Damage?

  Safe

  At Risk

  N/A

• Rear of Vehicle and Bumper Free of Damage (Tailgate if included)?

  Safe

  At Risk

  N/A

• Rear lights & indicators?

  Safe

  At Risk

  N/A

• How's My Driving and fleet number Label Intact?

  Yes

  No

• Rear Tyres in Good Repair with no Visible Signs of Wear or Cracking in Sidewall?

  Safe

  At Risk

  N/A

• Adequate Spare Tyre is Available if Necessary in Good Repair with No Visible Signs of Wear or Cracking in Sidewall?

  Yes

  No

  N/A

• Right Side Free of Damage?

  Yes

  No

  N/A

• Roof Racks Secure including Ladder & Pipe Racks?

  Yes

  No

  N/A

• Exterior clean?

  Yes

  No

Interior

• Mirrors Free of Damage?

  Yes

  No

  N/A

• Racking Secure

  Yes

  No

  N/A

• Interior is Clean and Free of Loose Objects?

  Yes

  No

• Jack and Roadside Tools Present?

  Yes

  No

Safety Equipment

• Securely mounted First Aid Kit (Ensure Completely Stocked)

  Yes

  No

• Fire Extinguisher Charged

  Yes

  No

  N/A

Required Documents

• Tax Expiry Date

  Date

• MOT Expiry Date

  Date

• Valid Vehicle Insurance, Transport waste certificate & Handbook

  Yes

  No

  N/A

Comments & Signatures

• Additional Comments

• Inspection Type

  Routine

  Received Vehicle Check

  Returned Vehicle Check

• Signature of Operative

  Sign

• Signature of Inspector

  Sign

• Fuel Gauge to Nearest 8th

• Spare Keys Included

  Yes

  No

  N/A

• Alarm / Remote Included

  Yes

  No

  N/A

• Is Recorded Mileage at Handover Correct

  Yes

  No

• Please Enter Correct Mileage

• Delivery Agent

  Sign

• Acceptance Signature I confirm that the vehicle has been checked and found to be acceptable upon delivery

  Sign

• Fuel Gauge to Nearest 8th

• Spare Keys Included

  Yes

  No

  N/A

• Alarm / Remote Included

  Yes

  No

  N/A

• Disclaimer
  This is a preliminary and does not constitute the final assessment. ALD reserves the right to appoint an independent assessor to inspect the vehicle upon the vehicle's return. The customer will be notified of the final assessment of the vehicle and any charge that may be payable by the customer as a result of excess fair wear and tear charges, together with a copy of the independent assessment of the vehicle to the customer in this respect.
  
  LESSEE
  The lessee agrees that the vehicle is as described and that the recorded mileage is correct. Lessee also acknowledges and agrees to the disclaimer.

• Is Recorded Mileage at Handover Correct

  Yes

  No

• Please Enter Correct Mileage

• Lessee Signature

  Sign

• Collection Agent I confirm that the oil and water levels were checked and found to be acceptable upon collection.

  Sign

ALD AUTOMOTIVE DE FLEET CENTRE

• DE Fleet Centre:
  

• Return Mileage:

• Date:
  

• Time:
  

• Comments
  
  
  
  
  
  
  
  
  

• 
  
  
  
  Signed Name Position

• Sponsor - G Wilson - East BU Ops Manager
  Compiled by - P Nielson
  Version Date - 17 Oct 14
  Review Date - Sep 15