Pre-Installation Checklist

Preliminary Information

• Site:

• SP No.

• Conducted on

  Date

• Client:

  Select Anglian Water Independent Scottish Water Severn Trent South West Southern Water Thames Water Welsh Water Wessex Water Yorkshire Water

  • Anglian Water
  • Independent
  • Scottish Water
  • Severn Trent
  • South West
  • Southern Water
  • Thames Water
  • Welsh Water
  • Wessex Water
  • Yorkshire Water

• Prepared by

• Location
  Address

• Personnel:

  Select John Gartside John Creamer Steve Pearce Ray Lewis Paul Rollinson Mike Greenman Tim Harrison Richard Malsom David Freeman Mitch Bunclark Mark Ward Gary Deaville Mark Burgess Mike Pritchard

  • John Gartside
  • John Creamer
  • Steve Pearce
  • Ray Lewis
  • Paul Rollinson
  • Mike Greenman
  • Tim Harrison
  • Richard Malsom
  • David Freeman
  • Mitch Bunclark
  • Mark Ward
  • Gary Deaville
  • Mark Burgess
  • Mike Pritchard

Section B- Data to be obtained/verified

• 1: Are there any special Health and Safety requirements associated with this site that we should be aware of? If YES provide details and ensure these are referenced on our RAMS

  YES

  NO

• Further details:

• 2: Is the are we will be working in a confined space? If YES provide details

  YES

  NO

• 3: Is there power supply to the equipment?

  YES

  NO

• Yes

  No

  N/A

• 4: Have you taken photographs?

  YES

  NO

• 5: Are there other people working on site?

  YES

  NO

• 6: Are there rubbish collection facilities ie skips, bins etc

  YES

  NO

• 1: Is there safe Access/Egress to the work area?

  YES

  NO

• Details of hazard(s) and what we propose to do about it

• 2: Is there safe storage of materials available?

  YES

  NO

• Details of hazard(s) and what we propose to do about it

• 3: Is there adequate supervision and control of work?

  YES

  NO

• Details of hazard(s) and what we propose to do about it

• 4: Is the atmosphere unhealthy or dangerous? ie gases, spray etc

  YES

  NO

• Details of hazard(s) and what we propose to do about it

• 5: Is there adequate lighting?

  YES

  NO

• Details of hazard(s) and what we propose to do about it

• 6: Do we have access to shelter, welfare facilities or mess rooms?

  YES

  NO

• Details

• 7: Do we have access to toilet facilities?

  YES

  NO

• Details

• 8: Do we have access to water and washing facilities?

  YES

  NO

• Details of hazard(s) and what we propose to do about it

• 9: Can we comply with the Method Statement?

  YES

  NO

• Reasons why not and any precautions we must take.

• 10: Is the flooring complete? Are access stairs etc safe to use?

  YES

  NO

• Reasons why not and any precautions we must take.

• 11: Is there any scaffolding or working at height?

  YES

  NO

• Details of hazard(s) and what we propose to do about it

• 12: Have we permission to use existing lift facilities and are they tested and checked?

  YES

  NO

• Details of hazard(s) and what we propose to do about it

• 13: Is the electrical equipment (110v or lower) tested?

  YES

  NO

• Details of hazard(s) and what we propose to do about it

• 14: Do we have all the PPE required to do the job safely?

  YES

  NO

• Details of hazard(s) and what we propose to do about it

• 15: Do we have the correct first aid kit and the training to use it?

  YES

  NO

• Details of hazard(s) and what we propose to do about it

• 16: Do we comply with the site safety plan?

  YES

  NO

• Details of hazard(s) and what we propose to do about it

• 17: Do we have fire extinguishers available?

  YES

  NO

• Details of hazard(s) and what we propose to do about it

• Are we happy that the site is safe to work on?

  YES

  NO

• Add signature

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