Information

  • Eurogold EG number

  • Client Name

  • Conducted on

  • Supervisor

  • Scheme name / Location
  • Site photo

Safety Observations

  • Housekeeping (free of hazards)?

  • Service avoidance - are statutory drawings / details available on site

  • Service avoidance (under and overhead) use of CAT & Genny

  • Are all personnel wearing appropriate PPE for the tasks being undertaken

  • Is Noise/dust being controlled to minimise risk and disturbance

  • Is Manual Handling(reduced where possible)

  • Is Fire protection and First Aid available on site

Traffic management

  • Are all signs and cones laid in accordance with New Roads & Street Works Act / Chapter 8

  • Is there a safe and clearly defined route for public / pedestrians?

  • Is the signage giving clear direction to vehicular traffic?

  • Does the Site layout look correct?

Quality

  • Are works following design and specification

  • Are the gang making expected progress?

  • Are the materials used as per specification

Drainage

  • Drainage

  • Is correct ironwork class in use?

  • Is line and level of pipe work correct to the design?

  • Are manholes and gullies constructed correctly?

  • Does bed and surround meet specification?

  • Are pipe joints closed?

Footways

  • Footways

  • Has all ironwork been adjusted to correct level?

  • Does the footway have a fall to allow free drainage i.e. no ponding?

  • Are asphalt layers the correct the correct thickness and compacted properly?

  • Is sub-base material properly compacted?

  • Has existing footway been excavated to correct depth?

  • Are kerbs laid to correct line and level?

  • Have kerb lines been excavated to correct depth?

Patching

  • Patching

  • Are patches planed to correct depth?

  • Has bond coat been applied to both base AND vertical edges?

  • Are patches compacted satisfactorily?

Jetting/gullying

  • Jetting/Gully Emptying

  • Is there evidence gully pots have been properly cleaned?

  • Have tops been cleaned and surround cut back?

Roadmarkings

  • Roadmarkings

  • Is line of the required quality?

  • Are the lines in the correct position?

  • Are the line spacings and line widths correct?

Safety Defects

  • Safety Defects

  • Have defects been saw cut with vertical edges?

  • Has bond coat been applied to both edges AND base?

  • Is asphalt hot and compacted?

Acknowledgement

  • Supervisor Signature

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.