Title Page

  • Project

  • Form Completed By

  • Location
  • Date / Time

Planning, Documentation and Records

  • Have the Clipfine supply chain safety procedures been issued to sub-contractor

  • Is there an accepted Clipfine coversheet on the RAMS/Lift Plan

  • Is there an accepted client coversheet on the RAMS/Lift Plan signed by relevant managers

  • Do sub-contractors have the correct competencies for the planned works and have the competencies been recorded on file in the Clipfine office

  • Have the sub-contractors been site inducted

  • For high risk activities such as excavations, has a responsible person been nominated by the sub-contractor and appointed in writing by Clipfine (Responsible person for buried services etc)

  • Does the sub-contractor have plant, tool and equipment certification in place (CE, PAT, LOLER)

  • Are all necessary permits in place

  • Has a daily safe start been carried out, and if so, is it to a sufficient standard

Workplace Arrangements

  • Is the works area/planned works area safe for works to proceed (Interface with other trades, lifting operations, plant operations etc)

  • Are exclusion zones in place, and if so, are they sufficient for the works being carried out

  • Is there safe access to the work area

  • Has all plant, tools and equipment been inspected (Pre-use, weekly recorded and any other requirements such as LOLER)

  • Are plant/vehicles compliant to site standards – CLOCS/FORS Silver, NRMM, Tail lifts fitted with handrail, FOPS, ROPS

  • Is all required PPE being worn, and is it in good condition

  • Has PPE been inspected (harnesses etc)

  • Are works being carried out as per RAMS/Lift Plan

  • Is health surveillance being carried out - HAVS, Noise, COSHH

  • Are emergency arrangements in place (Spill, first aid, fire)

  • Is there sufficient signage in place (Warning, Mandatory, Prohibition, Emergency signage etc)

  • Are suitable tool tethers being used

  • Is there suitable dust extraction/dust control measures in place

  • Is the work environment suitable

Sign Off

  • Inspection carried out by

  • Additional Attendees to Inspection
  • Additional attendees to inspection

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