Richard Irvin - energy solutions

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Job Address
  Address

• Date

  Date

• Crew members

• Photo of property

  Media

Inspectors name/signature of acknowledgement of responsibility to input accurate and true information, to clarify full compliance in line with the BBA/PAS2030 specification and requirements.

• Inspectors name and signature

  Sign

HEALTH & SAFETY

• On site arrival health & safety observation

  compliant

  non- compliant

• All PPE being used correctly?

  Yes

  No

  N/A

• Has dynamic risk assessment been carried out?

  Yes

  No

  N/A

• Photos of non-compliance

  Media

• Actions required

Health & safety equipment check

Harness inspection

• Crew leader harness condition visual check

  Select compliant non- compliant

  • compliant
  • non- compliant

• Harness asset number

• Photo of any defects

  Media

• Crew 2nd man harness condition visual check

  Select compliant non- compliant

  • compliant
  • non- compliant

• Harness asset number

• Photo of defects

  Media

• Actions required

Cowstail & ladder straps

• Crew leader Cowstail & ladder strap condition check

  Select compliant non- compliant

  • compliant
  • non- compliant

• Photo of defects

  Media

• Crew 2nd man Cowstail & ladder strap condition check

  Select compliant non- compliant

  • compliant
  • non- compliant

• Photo of defects

  Media

• Actions required

Health & Safety vehicle check

Documents

• Van pack

  Yes

  No

  N/A

• CIGA best practice manual

  Yes

  No

  N/A

• Crew leader ACOPs

  Yes

  No

  N/A

• Crew 2nd man ACOPs

  Yes

  No

  N/A

• Crew leader ID badge

  Yes

  No

  N/A

• Crew 2nd man ID badge

  Yes

  No

  N/A

• Survey

  Yes

  No

  N/A

• Notes/actions required

First Aid kit

• Contents complete

  Yes

  No

  N/A

• Photo of defects

  Media

Fire extinguisher

• In working order

  Yes

  No

  N/A

Ladders

• Visual check of ladders

  Safe

  At Risk

  N/A

• Asset numbers

Drill

• Visual check of drill and lead

  Safe

  At Risk

  N/A

• PAT test in date

  Yes

  No

  N/A

• Asset number

Power leads (110v)

• Visual check of leads

  Safe

  At Risk

  N/A

• PAT test in date

  Yes

  No

  N/A

• Asset numbers

Transformer

• Condition of transformer

  Safe

  At Risk

  N/A

• PAT test in date

  Yes

  No

  N/A

• Asset number

Hand tools

• General condition of tools

  Good

  Ok

  Poor

Generator

• Condition of generator/hopper

  Safe

  At Risk

  N/A

• Note defects

Installation spec check PAS 2030

Pre & post checks

• Have pre & post insulation checks been carried out?

  Yes

  No

  N/A

• Has a dynamic risk assessment been carried out?

  Yes

  No

  N/A

• Has customer contact been made?

  Yes

  No

  N/A

• Is survey form in order?

  Yes

  No

  N/A

• Has flue safety check been carried out?

  Yes

  No

  N/A

• Photo of any discrepancies

  Media

• Comments

Cavity wall insulation

• Cavity barriers installed where applicable?

  Yes

  No

  N/A

• All ventilation sleeved/Clear?

  Yes

  No

  N/A

• Drill pattern correct?

  Yes

  No

  N/A

• Blowing sequence correct?

  Yes

  No

  N/A

• Making good?

  Yes

  No

  N/A

• Colour match?

  Yes

  No

  N/A

• Site organisation/cleanliness?

  Good

  Ok

  Poor

Photos required

• Crew members wearing PPE

  Media

• 4 sides of van

  Media

• Cab of van

  Media

• Rear of van

  Media

Additional notes/photos

• Notes

• Additional photos

  Media