Safety Inspection - Spot Check

• Conducted on

  Date

• Document Ref:

• Inspector

• Location
  Address

• Department

  Gas

  Electric

  Communications

  Water

  Other

• Work Type

  Select Excavation Pipe Installation Cable Laying Jointing Reinstatement Other

  • Excavation
  • Pipe Installation
  • Cable Laying
  • Jointing
  • Reinstatement
  • Other

Site Details

• Job Reference

• Team Supervisor

• Team Leader

• Sub Contractor - if applicable

• Cient

• Abortive Visit

  Yes

  N/A

Administration

• Identification Cards (ID) available

  Yes

  No

  N/A

• Safe digs and pipeline / utility search results available on site

  Yes

  No

  N/A

• Work Instruction / Job Pack on site

  Yes

  No

  N/A

• Risk Assessment completed for site

  Yes

  No

  N/A

• Site operatives wearing all correct Corporate Work Wear

  Yes

  No

  N/A

Site Safety

• Is the site tidy / good housekeeping

  Yes

  No

  N/A

• Services marked / pilot holes taken where necessary

  Yes

  No

  N/A

• HI Viz / Hard Hat and other PPE worn where risk exists / identified

  Yes

  No

  N/A

• Excavation safe and shored where necessary

  Yes

  No

  N/A

Signing, Lighting and Gaurding

• Information / Permit / Apology Board (with MMG or Client contact telephone no.)

  Yes

  No

  N/A

• Vehicles and equipment positioned safely

  Yes

  No

  N/A

• Signs – spacing, size, condition, weighted

  Yes

  No

  N/A

• Safety zones – lead in and exit tapers provided

  Yes

  No

  N/A

• Cones and barriers – location, size, condition

  Yes

  No

  N/A

• Pedestrian walkway – minimum width, ramps provided where required

  Yes

  No

  N/A

• Correct type of traffic management provided as per COP, if using traffic lights, are stop / go boards available (in case of traffic light failure)

  Yes

  No

  N/A

• Stores and materials guarded

  Yes

  No

  N/A

Plant, Tools, Equipment and Vehicles

• Correct plant, tools and equipment being used

  Yes

  No

  N/A

• Plant, tools and equipment in good condition

  Yes

  No

  N/A

Environmental

• Spoil / waste segregated and sited correctly

  Yes

  No

  N/A

Stop Work

• Does the work need to stop for any reason

  Safe

  At Risk

If there are any non-compliances (or NO’s) to the above, please give details below

• Summary of findings

Sign Off

• Team Leader

  Sign

• Inspector

  Sign