Title Page

  • Conducted for -

  • Conducted on

  • Auditor

  • Location
  • Team Leader/Jointer

  • Team Member(s)/ Jointers Mate

Site Documentation

  • 1.1 Have the team completed the SSRA and have all visitors & agents signed on ?

  • 1.2 Is a copy of the team pack on site?

  • 1.3 Are copies of all utility plans on site, in colour and in date?

  • 1.4 Is the team in possession of a DNO ID Card or covering letter and are their copies of authorisations on site

  • 1.5 Do the competencies match the tasks on site (i.e. face fit/abrasive wheels etc CSCS Cat & Genny), list all with expiry dates.

Vehicle

  • 2.1 Have the team completed daily check of the vehicle (inside & outside), and is the vehicle clean and tidy?

  • 2.2 Does the vehicle have fitted an in date secured 2kg dry powder fire extinguisher?

  • 2.3 Is the vehicle and trailer parked as not to cause obstruction or hazard?

  • 2.4 Is a no smoking sign present in the vehicle cab and is the vehicle smoke free?

  • 2.5 Are loads safe and correctly secured to the vehicle.

Trailer

  • 3.1 Is the mini digger secured with 3 straps to the trailer or 3 straps available on site to secure? And are they in good condition?

  • 3.2 Do all trailer lights work and does the trailer registration match the van?

  • 3.3 Is the breakaway cable used/serviceable and is there a jack wheel present?

  • 3.4 Is the overall weight of the load being towed exceeding the limit?

Plant and Equipment

  • 4.1 If any lifting equipment is available is it in date?, provide expiry dates:

  • 4.2 Have daily checks been completed of the excavator and is valid documentation on site (service). provide service date:

  • 4.3 Are insulated tools being used when hand digging and in good condition?

  • 4.4 Are all plant and equipment in good condition and calibrated? Provide and list all equipment with calibration dates. i.e. Cat & Genny/breaker/floor saw/Stihl saw etc

  • 4.5 Are all jointers tools within their test/calibration period and labelled correctly?

  • 4.6 Is water suppression available for cutting tools i.e. Road saw/Stihl saw?

  • 4.7 Have the team completed a Weekly Plant and Equipment Check sheet – QF 70?

PPE

  • 5.1 When required are teams wearing ARC PPE?

  • 5.2 Are the jointers wearing insulated boots and gloves and do they have spare PPE available?

  • 5.3 Is all PPE in good conditions?<br>(boots/glasses/coveralls etc) and the correct type for the task?<br>

  • 5.4 Is the correct PPE being worn for the task being undertaken?

Excavation

  • 6.1 If required is the excavation suitably supported by means of Temporary Works?

  • 6.2 Is suitable access and egress made available for the excavation? (step in/out)?

  • 6.3 Is spoil stored away from the edge of the excavation?

  • 6.4 Is all spoil stored inside the barriers?

  • 6.5 Has the minimum depth and width been achieved as per client requirements?

  • 6.6 Is the trench bottom free from, sharps and general rubbish?

  • 6.7 Where any street furniture is present within the excavation has consideration been given to prevent damage or collapse?

Backfill and Excavation

  • 7.1 Is correct material being used for reinstatement i.e. HRA/SMA/flags/blocks etc?

  • 7.2 Have edges of reinstatement been sealed with water resistant edge sealant?

  • 7.3 Is the working area tidy?

  • 7.4 Have all road markings been replaced?

Kerb ramps and Foot boards

  • 8.1 If required are kerb ramps/footboards in use, pinned and in good condition (includes non-slip boards) to prevent slips, trips and falls?

  • 8.2 Has the correct type of board been used? i.e. driveways/footpaths/kerbs?

Barriers

  • 9.1 Are all barriers in good condition? :<br>Interlocked, Same type, weighted and feet in good condition.<br>

Signs

  • 10.1 Are all signs in good condition and are weighted with a sandbag on to stop them overturning?

  • 10.2 Is a courtesy board and permit number displayed on site and secured correctly?

Footway Closure

  • 11.1 When the footway is closed is an adequate alternate available?<br>i.e. Temp walkway, adequate signage, alternative footpath identified & suitable MOP protection<br>

  • 11.2 If a temporary footway is in place is the minimum distance of 1m provided?

Protection of Utilities

  • 12.1 Is there evidence to show the area of excavation has been scanned?

  • 12.2 Have trail holes been dug to positively locate all known services?

First Aid

  • 13.1 As a minimum, is there a 1 day First Aider on site?

  • 13.2 Is a First Aid kit, burns kit and eye wash available on site, in date fully stocked?

Health

  • 14.1 If vibrating tools are being used on site, are they being recorded within the SSRA?

  • 14.2 Are the team aware of the vibration magnitude of their tools i.e. colour coded tags on vibration tools?

  • 14.3 Where dust is being produced, have staff been face fitted and have a FFP3 dust mask available?

  • 14.6 Is ear defense available on site if required and in good condition?

  • 14.9 Are arrangements in place to allow hand cleaning prior to eating?

  • 14.10 Have suitable welfare facilities been identified for use?

  • 14.11 Does the team have sufficient COVID 19 sanitising equipment? I.e. hand gel, wipes/disposable gloves/visors etc?

  • 14.12 Do the teams know what action to take in the event of trespass/vandalism incident occurring?

Quality

  • 15.1 Is the cable depth correct?

  • 15.2 Is the duct at the correct depth?

  • 15.3 Is the Tile tape correct at the point of installation?

  • 15.4 It the Tile tape secure?

  • 15.5 Is the trench sanded?

  • 15.6 Are works provided by 3rd parties i.e builders to correct spec?

  • 15.7 Have all road markings been replaced?

Environment

  • 16.1 Is a spill kit available on site?

  • 16.2 Is waste correctly segregated for disposal (cable cut off/spoil etc) ?

  • 16.3 ? Are all COSHH items being stored correctly with a COSHH assessment on site?

  • 16.4 Are fuels stored in correct container and labelled?

  • 16.5 Is the work being undertaken to avoid tree or hedge roots?

  • 16.6 Are the team aware of their environmental controls (noise/dust etc)?

Working at height (WAH)

  • 17.1 Are the team using assisted WAH (ladders/harness/MEWP) equipment? If yes complete inspection QF?? For specific WAH compliance, if not continue on QF023.

  • 17.2 Are the controls in the RAMS for working at height suitable for the task (discuss with the team)?

  • 17.3 Is suitable edge protection or controls implemented when working off flatbed vehicles?

Are there any other notable issues/ good practice worth recording?

Debriefing

  • Have the team been debriefed on the findings?

  • Any further feedback ?

Sign off and close out

  • Is this audit free from any NON-CONFORMANCES. If you have identified any non-conformances what have you done about it before leaving site.

  • Auditors Signature

  • Team Leaders 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.