Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location
  • Site Manager

  • Site consists of

  • Site is classed as a :

  • Description of site and / or activities taking place at time of inspection

Plant and Equipment

  • Is Electrical Plant and equipment included in the inspection

  • The High voltage equipment is in a secured area with adequate signage?

  • The MCC Panels are in a secured area with adequate matting and signage

  • All portable appliances have been PAT inspected and are in date

  • The use of extension leads and multiple sockets do not present a fire risk. Leads do not trail and all equipment is in good working condition.

  • Where in use, LOTO is being correctly applied

  • Is Pressure vessels icluded in the inspection?

  • All presure vessels are on the Allianz inspection register, with up to date records

  • Is mechanical equipment included in this inspection?

  • All equipment has adequate guarding in place to prevent harm

  • Emergency isolation stops are in place and clearly identifiable and visible

  • All regulatory signage is present and in good condition (Hazard and PPE)

  • Is Lifting equipment included in this inspection

  • What lifting equipment is present on site?

  • The Safe Working load is clearly displayed on the equipment

  • There is evidence of statutory inpections clearly visible on the equipment / Accessories and in date

  • FLT - Signage is clearly displayed warning of FLT movement

  • FLT - Operators are trained and competent

  • FLT - Pre-use checks are being performed and recorded with evidence on site

  • FLT is in good condition with no defects

  • FLT - There is evidence of planned preventative maintenance

Hazardous Substances / Chemical Management

  • Is there Hazardous Gas on site?

  • Does the site contain Chlorine and / or Sulphur Dioxide

  • Chlorine / Sulphur Dioxide - The storage room protected from vehicular damage (5m from any roadway or provided with crash barrier)?

  • Chlorine / Sulphur Dioxide - There are lights indicating safe entry and they are in good working order?

  • Chlorine / Sulphur Dioxide - There is suitable ventilation to the storage/dosing rooms

  • Chlorine / Sulphur Dioxide - Cylinders are secured by clamps

  • Chlorine / Sulphur Dioxide - Chlorguard is in place and within inspection date

  • Chlorine / Sulphur Dioxide - Cylinders are protected from excessive heat and sunlight

  • Chlorine / Sulphur Dioxide - Gas detection is present in the storage and dosing room

  • Chlorine / Sulphur Dioxide - Gas detectors have been inspected within the last 6 months

  • Chlorine / Sulphur Dioxide - Connection pigtails have been replaced in the last year

  • Chlorine / Sulphur Dioxide - A chemical hazard information sheet (CIS) is displayed at point of use

  • Chlorine / Sulphur Dioxide - An emergency shower is available?

  • Chlorine / Sulphur Dioxide - There is a windsock that is clearly visible on and off site?

  • Chlorine / Sulphur Dioxide - There are no houses within 20 meters of the gas store?

  • Ozone - The control board is separate from the generating plant itself

  • Ozone - The storage/dosing rooms have suitable ventilation

  • Ozone - gas detection is present in the dosing room

  • Ozone - Lights indicating safe entry are in good working orde

  • Ozone - Gas detectors have been checked within the last 6 months

  • Ozone - A chemical hazard information sheet (CIS) is displayed at point of use

  • Gas Cylinders - The cylinders are adequately secured in an upright position (chains etc.)

  • Gas Cylinders - The cylinders protected from excess heat/sunlight

  • Gas Cylinders - All fittings and hoses are in good condition

  • Gas Cylinders - gas is protected against unauthorised use/theft

  • Gas Cylinders - The gas containers are clearly marked

  • Gas Cylinders - Empty containers are stored separately away from full containers

  • Gas Cylinders - A chemical hazard information sheet (CIS) is displayed at point of use

  • Are there Chemicals or other hazardous substances on site?

  • COSHH Assessments are available an up to date

  • Material Safety Data Sheets (MSDS) are available and current

  • Emergency facilities are present and in good working order i.e. Eyewash, Emergency Showers

  • The storage / delivery area is bunded

  • There is suitable and sufficient signage warning of the dangers and the safet measures to take

  • Does the site contain asbestos?

  • The controls in place for identifying and managing asbestos is suitable and sufficient

  • Is Legionella identified as a risk on site?

  • Monthly temperature monitoring, Flushing and disinfection is undertaken, with records to evidence the activities.

Emergency Response

  • Fire Risk assessment has been completed for the site within the last 5 years

  • All evacuation routes are clearly signed and clear from obstructions

  • Emergency lighting is in good working order

  • All fire equipment is accesible with evidence of an inspection within the last year

  • If applicable, a fire drill has been conducted on site within the last 6 months?

  • If applicable, are the operatives trained in the safe use of RPE, with suitable RPE on site, in clean good condition and evidence of pre-use inspections.

  • If applicable, are there spill kits on site?

  • If applicable, is there a grab bag on site, with all relevant emergecny information contained within?

  • First aid kits are available, fully stocked and in date.

Security / Building / Perimeter

  • Site is secure, perimeter fence is in good condition and doors are kept shut/ locked

  • Walksways are clear and segregated from vehicle where possible

  • All manhole covers and valve pits are suitably covered, preventing any slip, trip and fall hazards

  • Hatches and Kiosks are locked shut with SEW padlocks

  • The structure of the building is in good repair, with no evidence of water ingress

  • Lighting inside and outside the building is in good working condition and suitable for he activities being undertaken

  • Waste mangement is adequate

  • If applicale, suitable welfare facilities are available on site

  • Is open water on site i.e. Lagoons, Open reserviors, open tanks

  • All areas with open water is fenced if suitable, or appropriately signed to warn of the dangers and life saving epuipment is provided

  • Edge protection is present around tanks to prevent falls and suitable toe boards if applicable to prevent falling objects.

  • Are there areas which pose a risk of falls from height, such as stairs , steps, ladders etc.

  • Stairs / Steps and fixed ladders are in good condition with suitable handrails. Fixed ladders have suitable safety hoops or fall arrest measures and have ladder guards fitted.

  • Portable ladders are in good condition with evidence of pre use checks being conducted

  • All gantry grids are clamped / secured down to prevent movement

  • If applicable, racking is in good condition with no evidence of defect. Racking inspection are being undertaken and recorded

H&S Behaviours

  • If applicable, all employees are wearing the correct PPE at all times

  • If applicable, visitors are signed in and given an induction to site

  • Employees are seen to be working in a safe manner with no indication of safety breaches or shortcuts

Other Hazards

  • Are there any other hazards identified on site which are not compliant and pose a safety risk to those working on site

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.