Information

  • 3CIX RA UG Survey

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Site Risk Assessment

  • Are there any obvious physical hazards that may affect the Operatives on site? E.g.exposed wiring, loose fittings, damaged pathways, decay pole??

  • Are there any unsafe areas the Operatives must access or pass through to complete their work?

  • Are there sufficient arrangements to avoid sharp injuries? Safety Gloves, PPEs.

  • Is team is fully equipped with required PPEs and tools?

  • Is there adequate lighting on site whilst operatives are working?

  • Is Vehicle in working condition and has Cheveron and working beacon lights ?

  • Are all barriers set up properly and correctly as per code of practice?

  • Do operatives have relavent training certification availble on site?

  • Does the operative have work specific risk assessment and method statement available?

COSHH Assessment

  • Is there first aid box, qualified first aider available to deal with emergency?

  • Is there COSHH items waste disposal process for the site operatives? E.g fiber sharps bin

  • Is work site tidy and free form tripping hazard?

  • Is Working GDU available for gas testing before operating in confined space?

  • Are there enough safety measures in place to perform activity safely Without being exposed to harmful/hazardous substances) ?

  • Are there any environmental issues on site that affect the operatives? Extreme weather, hazardous gases , fumes and dust, noise above acceptable limit?

  • Is there anything hazardous that the Operatives need to work with, near or dispose of? E.g. Laboratory, fuel depot, bulk chemicals, train tracks, Highway?

  • Closing Comments:
  • Team Lead/Supervisor Name

  • Signed by person filling the form

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