QEHS Site Audit Report

• Site conducted
  Address
• Add location
  Address

• Conducted on

  Date

• Prepared by

• Audit Number

• Crew Leader

• Audit End Time

  Date

• Crew Members

• 1. JSSP completed and available

  Compliant

  Non-Compliant

  N/A

• Photo No

  Media

• 2. Job pack / T2 Available

  Compliant

  Non-Compliant

  N/A

• Photo No

  Media

• 3. Service Maps (Gas, ESB, Water, Telecoms)

  Compliant

  Non-Compliant

  N/A

• Has SAP been started

  Compliant

  Non-Compliant

  N/A

• Photo

  Media

• 4. Safepass / CSCS Cards Available

  Compliant

  Non-Compliant

  N/A

• Photo No

  Media

• 5. Site Documentation

  Compliant

  Non-Compliant

  N/A

• (Method Statement, Risk Assessments, SOPs)

  Compliant

  Non-Compliant

  N/A

• Photo No

  Media

• 6. Signage

  Safe

  At Risk

  N/A

• 7. Guarding / Barriers

  Safe

  At Risk

  N/A

• Photo

  Media

• 8. Pedestrian Routes

  Safe

  At Risk

  N/A

• Photo No

  Media

• 9. Housekeeping

  Good

  Fair

  Poor

  N/A

• Photo No

  Media

• 10. Storage of Materials

  Good

  Fair

  Poor

  N/A

• Photo No

  Media

• 11. Tools & Equipment are defect free

  Compliant

  Non-Compliant

  N/A

• Photo No

  Media

• 12. Access & Egress

  Safe

  At Risk

  N/A

• Photo No

  Media

• 13. Private Property

  Yes

  No

  N/A

• Are vehicles and plant parked safely and not causing obstruction ?

  Safe

  At Risk

  N/A

• Photo No

  Media

• 14. Excavations

  Safe

  At Risk

  N/A

• (Public / Private, Are they safe?)

  Safe

  At Risk

  N/A

• Has Ground Been Scanned prior to Excavation ?

  Yes

  No

  N/A

• Is appropriate PPE being worn and used correctly ?

  Compliant

  Non-Compliant

  N/A

• Photo No

  Media

21. Services listed on JSSP

• ESB

  Yes

  No

  N/A

• Gas

  Yes

  No

  N/A

• Public Light

  Yes

  No

  N/A

• Water

  Yes

  No

  N/A

• Traffic Lights

  Yes

  No

  N/A

• Telecom

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

• services found

  Yes

  No

  N/A

Manager check List

• Crew Leader folder

  Yes

  No

  N/A

• Tools & Equipment

  Yes

  No

  N/A

Safepass / CSCS card

• Has a crew member got SLG ?

  Yes

  No

  N/A

• Guarding / Barriers

  Yes

  No

  N/A

• Has a crew member got LUGS ?

  Yes

  No

  N/A

• PPE

  Yes

  No

  N/A

• Excavations

  Yes

  No

  N/A

Permit to work (T2)

• Signage

  Yes

  No

  N/A

On site safety Folder

• Pedestrian Routes

  Yes

  No

  N/A

• Vehicle Security &

  Yes

  No

  N/A

TMP

• Have You the Auditor Consulted with Crew Leader & General Operatives in relation to the outcome of this site audit: Yes

• If Not , Please state Reason:

• Crew Comments / Acknowledgments