Title Page
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Team leaders name
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Operative Name/s
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Location Address
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Work in Progress
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Vehicle Reg
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Sub-Contractor (If Applicable)
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Contract i.e. LVO/ NCS
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Civils or Jointing
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Linbrooke Manager
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Person Completing checks:
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Date of Van Check
Van Check
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Have the team completed the SSRA and have all visitors & agents signed on?
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Is a copy of the van pack on site and what date is shown on Risk assessments within?
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Date on Risk Assessment
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Are relevant COSHH statements in Van Pack? And in date?
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Do the competencies match the tasks on site (i.e. face fit/abrasive wheels etc CSCS Cat & Genny)?
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Does the vehicle have fitted an in date secured 2kg dry powder fire extinguisher?
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Date on fire extinguisher
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Is at a minimum 1 x First Aider on site?
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Date on certificate
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Is a First Aid kit available and sufficiently stocked and in date where applicable - <br>• individually wrapped sterile plasters of assorted sizes<br>• individually wrapped triangular bandages, <br>• safety pins<br>• large and medium-sized sterile, individually wrapped, unmedicated wound dressings<br>• disposable gloves
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Is eye wash available and in date?
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Where dust is being produced, have staff been face fitted and have a FFP3 dust mask available
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Is ear defence available on site if required and in good condition?
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Is all PPE in good conditions?<br>(boots/glasses/coveralls etc) and the correct type for the task?
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If Civils, do team have impact Googles available onsite fore use?
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Are all jointers tools within their test/calibration period and labelled correctly?<br>Looptester/ Proving Unit/ Megga
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Is a spill kit available on site?
Any Required Equipment / PPE?
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Please list if required
Sign Off
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Completed by -
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Operative sign off -
