Service Engineers

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Arrival, off loading,

• Have you signed In?

  Yes

  No

  N/A

• Are all operatives aware of site emergency procedures?

  Yes

  No

  N/A

• Is there good pedestrian/vehicle segregation measures on site?

  Yes

  No

  N/A

• Is there a Safe route to your workplace?

  Yes

  No

  N/A

• ?

  Yes

  No

  N/A

• Have operatives received a Tool Box Talk recently?

  Yes

  No

  N/A

• Can they remember when it was and what subject it covered?

  Yes

  No

  N/A

Personal Protective Equipment (PPE)

• High-Vis Vests Worn?

  Yes

  No

  N/A

• Hard hat?

  Yes

  No

  N/A

• Suitable gloves for task?

  Yes

  No

  N/A

• Safety footwear?

  Yes

  No

  N/A

• Hearing Protection?

  Yes

  No

  N/A

• Eye Protection?

  Yes

  No

  N/A

• Is PPE in good condition?

  Yes

  No

  N/A

Working at Height

• Will you be working at height?

  Yes

  No

  N/A

• Are measures in place to prevent falls from height?

  Yes

  No

  N/A

• Scaffold Towers - record of daily inspection? / Equipment in good visual condition? / Operatives hold relevant certification to erect and alter towers (PASMA)?

  Yes

  No

  N/A

• Ladders - Suitable equipment for task? / Clearly identified? / Evidence of inspection? / Good visual condition?

  Yes

  No

  N/A

• Mobile elevated work platforms (MEWPS) - record of daily inspection? / Operators hold valid licence to operate (IPAF)? / equipment being used safely?

  Yes

  No

  N/A

• Yes

  No

  N/A

• Safety Harnesses - Are they being worn correctly? / Evidence of inspections? / Used correctly? / measures in place to rescue operative in case of fall? / Harnesses in good visual condition?

  Yes

  No

  N/A

Plant

• Have plant operators got the correct licences? / certification ( I.e. Fork lift truck, Moffett, Crane)

  Yes

  No

  N/A

Working Environment

• Noise - Suitable precautions to warn others (signs etc.) Is suitable protection being worn?

  Yes

  No

  N/A

• Dust - Is the area very dusty? / Is the operation causing excessive dust? / is suitable PPE being worn? / Are steps being taken to reduce the level of dust?

  Yes

  No

  N/A

• Lighting - is the adequate lighting to safely access work area? / Adequate lighting to allow safe working?

  Yes

  No

  N/A

• Access - is there safe access to the work area - are there adequate walkways?

  Yes

  No

  N/A

• Are access walkways in good condition?

  Yes

  No

  N/A

• Is there suitable access platforms around all items of plant?

  Yes

  No

  N/A

• Lone Working - if operative is line working has measures been taken to ensure lone workers safety?

  Yes

  No

  N/A

• Are customers and others Warned about and protected from any work taking place?

  Yes

  No

  N/A

• Are materials and work equipment being stored son as not cause an hazard to others in the work area?

  Yes

  No

  N/A

Electricity

• Portable Electric Tools - Are tools / leads in good visual condition? / Have they been PAT tested and display a valid certification label showing when tested?

  Yes

  No

  N/A

• Are any leads in use positioned safely / Measures taken to prevent people tripping over them?

  Yes

  No

  N/A

• Yes

  No

  N/A

• If working on electrical circuits has the circuit been isolated and tested to confirm dead?

  Yes

  No

  N/A

• Has any isolated circuit been "locked off" using lock off hasp & padlock where appropriate?

  Yes

  No

  N/A

Leak Detector

• Functionality check against TEK-Check leak detector leak reference (hfc only)

  Yes

  No

  N/A

• Visual inspection good condition<br>

  Yes

  No

  N/A

Hot Works

• Gas Cylinders - Secured in a trolley / Cage?

  Yes

  No

  N/A

• Fire extinguishers - Available within close proximity to work area? / Tested & Displaying valid test label? / Suitable for task?

  Yes

  No

  N/A

• Gauges - In good condition?

  Yes

  No

  N/A

• Hoses - In good visual condition?

  Yes

  No

  N/A

• Flash back arrestors fitted - in Good condition? / inspected?

  Yes

  No

  N/A

• Hot works permit?

  Yes

  No

  N/A

• Has the work been assessed / permit issued by someone holding an FPA fire Safety Passport? (Mandatory requirement on Tesco Stores)

  Yes

  No

  N/A

Gas Works

• Has engineer got up to date reference manual, I.e. Vipergas?

  Yes

  No

  N/A

• Has engineer got calibrated analyser / manometer?

  Yes

  No

  N/A

• Has engineer got warning notice pad and stickers?

  Yes

  No

  N/A

• Is engineers Gas Safe Register card valid?

  Yes

  No

  N/A

• Is engineer qualified for gas works being undertaken?

  Yes

  No

  N/A

Lifting Equipment

• Crane on site? - Crane Checklist completed? / Qualified bandsman present? / Lifting area barriered off to prevent others entering area?

  Yes

  No

  N/A

• Lifting Accessories ( Slings, Strops, Chains etc.) - In good visual condition? / Certified & Formally inspected within the last 6 months?

  Yes

  No

  N/A

Permits

• Electrical?

  Yes

  No

  N/A

• Hot Works?

  Yes

  No

  N/A

• Confined Space?

  Yes

  No

  N/A

• Work at Height?

  Yes

  No

  N/A

• Disconnection of Fire Alarm / Sprinkler System?

  Yes

  No

  N/A

• Crane Lift?

  Yes

  No

  N/A

• Other permits Issued / Required?

  Yes

  No

  N/A

COSHH

• Are hazardous substances suitably stored?

  Yes

  No

  N/A

• Are COSHH assessments available for all hazardous substances being used? / Are operatives aware of any assessments and necessary precautions?

  Yes

  No

  N/A

• Do operatives have a COSHH Manual?

  Yes

  No

  N/A

Storage / Housekeeping

• Storage container - Tidy? / Secure? / no cylinders stored in container? / Adequate ground conditions with safe access & egress?

  Yes

  No

  N/A

• Cylinder cage? / Locked?

  Yes

  No

  N/A

• General Housekeeping - Are work areas tidy and amount of waste minimised / stored safely? / Are walkways clear and unobsructed?

  Yes

  No

  N/A

• Is plant room clean and tidy? Are Space Engineering / Client storing items in the plant rooms?

  Yes

  No

  N/A

• If the plant room is being used for storage of materials is this causing a safety hazard, I.e. Exist blocked / combustibles etc?

  Yes

  No

  N/A

• If plant situated on the roof is the roof free from redundant equipment, I.e. No cylinders / compressors, oils etc, left on roof.

  Yes

  No

  N/A

Welfare

• Are general site conditions adequate?

  Yes

  No

  N/A

• Are there suitable toilets / washing facilities?

  Yes

  No

  N/A

• Are there first aides present? - Do operatives know who first aides are and how to contact?

  Yes

  No

  N/A

Reporting

• Are operatives aware of the need to report accidents, near misses and site hazards? / Do they know who to report to?

  Yes

  No

  N/A

• Are site operatives reporting accidents, near misses and site hazards? - Is there evidence of this?

  Yes

  No

  N/A

Asbestos

• If building built prior to 2000 has an asbestos register been made available to operatives? / Has this been viewed? / Is asbestos present in work area? / Are suitable precautions been taken to prevent accidental damage to any asbestos present? / Do operatives understand hazards associated with asbestos?

  Yes

  No

  N/A

Vehicle

• Is the operatives vehicle in a road worthy condition?

  Yes

  No

  N/A

• Are tyre treads above the wear markers? Do the tyres appear sufficiently inflated?

  Yes

  No

  N/A

• Does the vehicle appear to be overloaded?

  Yes

  No

  N/A

• Are the contents of the vehicle suitably secured, I.e. Are gas cylinders secured to prevent failing over?

  Yes

  No

  N/A

• Are fire extinguishers being carried on the vehicle for site hot works? - C02 and foam / Water or Powder

  Yes

  No

  N/A

• Is There a first aid kit on the vehicle?

  Yes

  No

  N/A

Other items identified

• Signed:

  Sign

• Document No.

• Audit Title