Title Page
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Prepared By
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Conducted On
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Location
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Operatives On Site
Worksite & Documentation
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RAM'S Completed For The Task Being Carried Out & if applicable Point of Work Risk Assessment (POWRA) completed and staff<br>briefed and signed on to POWRA?
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Pre Works Checklist Completed
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Site visitor record on site?
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Work pack / Van pack available on site?
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Housekeeping on site is good / site clean and tidy?
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Vehicles / vans and trailers parked safely, not causing an<br>obstruction to other road users or pedestrians?
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NRSWA Supervisor / Operative on site with Unit 2 - signing,<br>lighting and guarding and other competencies for works<br>being underaken?
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Red Book (Safety at Street Works and Road Works ACOP)<br>available on site?
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Are signs positioned correctly, secured, clean and in good condition?
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Sufficient barriers in place and in good condition?
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Barriers adequately secured / clipped together and prevented<br>from blowing over with sandbags?
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Appropriate safety zones in place and maintained?
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Has a pedestrian walkway been provided where required?
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Courtesy board in place, clean, easily readable and contains<br>relevant information (i.e. correct permit number, emergency<br>phone number etc.)?
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GDU switched on and being used correctly and in calibration?
First Aid
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First aider(s) identified and on site?
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First aid box available on site, Including eyewash, adequately stocked and in date?
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Are operatives aware of the incident / near miss reporting procedure and emergency arrangements (evacuation, fire, accident etc) in place and relevant to the site?
PPE & Safety Equipment
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Correct PPE For The Task Carried Out?
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PPE 6 monthly checked (Harness, Hard Hat, Ladders Etc)?
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Hand/wet wipes available of site for staff to clean hands?
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Flame Retardent PPE warn on Civils Works?
Enviroment
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Are all materials, including waste stored within the work area
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Is waste, including materials, contaminated soils, silts and<br>water disposed of correctly?
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Are recovered ropes properly collected and disposed off?
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Is a Spill Kit readily available?
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Fire extinguisher readily available and tested and in date?
Power Tools
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Power Tool Check (Check Quantum Owned Equipment) (Take Photos Showing The Condition Of Equipment and S/No) (Inc Batteries)