Risk Assessment Underground Survey

• 3CIX RA UG Survey

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Do operatives have relavent training certification availble on site?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

COSHH Assessment

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Is work site tidy and free form tripping hazard?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• 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?

  Yes

  No

  N/A
Closing Comments:

• Team Lead/Supervisor Name

• Signed by person filling the form

  Sign