Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Type of Survey

  • undefined

  • Overview of site location and general description of planned works

  • Full address of site

Surrounding Environment

  • Site overview

  • Surrounding roads nearby. Description of type - any anticipated access issues

  • Delivery Arrangements (Client)

  • Location of Service Yard and arrangements if applicable

  • Site boundary - is it secure? Is hoarding required?

  • Are there existing properties on site?

  • Parking for Contractors available?

  • Other buildings in close proximity? Description of type

  • Watercourses nearby?

  • Railways nearby?

  • Public right of way?

  • Is the ground & gradient suitable for landing cabins? Consider getting the supplier to survey if in doubt.

  • Are there any overhead lines to consider?

  • Any schools in proximity to site?

  • Flora & Fauna which may be affected e.g. Japanese's Knotweed, TPO's, wildlife surveys required

  • Are existing utility services affected? Description below

  • Are there suitable ground surveys in place (GPR as a minimum, desktop study only not acceptable)

  • Fire Hydrant/Water supply in close proximity?

  • What are the ground conditions? Will there be requirement to prepare suitable ground for MEWPS/Cabins/Cranes/scaffolding etc

  • Material & plant access routes & available openings

Establishing Site Set Up

  • Operating hours

  • Current use of Site?

  • Existing hazards/risks? (including any services below/above ground)***

  • Location of existing Fire Assembly Point

  • Location available for compound

  • Can we install temporary connections to existing services (water, power, drainage)

  • Preparation of area required pre start on site for compound? Is gradient an issue? Consider asking the cabin supplier to survey if in doubt

  • Site set up requirements

  • Please specify number & size, is a suitable area available? (measurements required)

  • Delivery arrangements to compound/site - Identify any hazards or restrictions

  • Segregation Requirement

  • Material offloading facilities available? (Client FLT availability)

  • Material offloading required to be provided by HB, forklift etc?

  • Material storage requirements

  • Will a 415V power supply be required for any part of the works?

CDMC Considerations

  • Has PCIP information been received?

  • Existing O&M Manuals available?

  • Existing Asbestos Survey available? (R&D survey of relevant areas required for any intrusive works)

  • Noise restrictions in place?

  • Structural survey available?

  • Planning Restrictions/Issues known?

  • Dust control measures required

  • Are there any other works planned on this site? (by others)

Health & Safety

  • Are there any specific or unusual health/safety risks to consider? Please detail

  • Hazardous waste to be considered?

  • Area available for recycling eg Skips

  • Any fragile structures/materials evident?

  • Evidence of Asbestos Containing Materials (ACM's)?

  • Risks to public during project?

  • Evidence of designated footpaths and short cuts

Project Specifics (Works to be considered during project)

  • Craneage required?

  • Concrete pumping?

  • Piling?

  • Groundworks?

  • Demolition?

  • Confined spaces?

  • What temporary works will be required on this project?

  • Heras

  • Solid hoarding

  • Excavation support (standard solution)

  • Excavation support (designed)

  • Propping (standard solution)

  • Propping (designed)

  • Scaffolding (Standard)

  • Scaffolding (designed)

  • Other - please state

  • Roof edge protection

  • Refrigeration Works?

  • Is roof access required? Detail the access/ roof type/ gradient. Is edge protection required?

  • Rooftop plant - type & quantity

  • Existing case route into Store?

  • Fixtures Works?

  • Resurfacing & line marking? (will site compound location be affected?)

  • Existing goods/passenger lifts - size & SWL

  • High Level clean - Internal and External condition

Work at Height

  • Scaffold/Edge protection required?

  • Roof works to be carried out?

  • MEWP's/Telehandlers required?

  • Fall arrest provision currently in place?

  • Rescue Equipment/Plan required?

Existing Store specific items

  • Condition & type of existing floor surface (internal)

  • Sprinkler system?

  • Emergency lighting (operational/tested)?

  • ATM on site? Liaise with store regarding any access issues

  • Action Required/By Who/Date Required

Additional Notes

  • Notes:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.