SIS Safety, Quality & Environmental Inspection Form CDM Site Set Up

• Project

• Auditor

• Project Manager

• Site Manager

• Location
  Address

• Date

  Date

• Time arrived

  Date

• Duration

• Score, 0=No Compliance 1=Some Compliance 2=Compliance N/A=Not Applicable

1. Facilities / Welfare

• 1.1 Are site welfare facilities on site?

  0

  1

  2

  N/A

• 1.2 Are they adequate for the number of operatives in line with legislation?

  0

  1

  2

  N/A

• 1.3 Are they clean?

  0

  1

  2

  N/A

• 1.4 Is the Law poster present and filled in?

  0

  1

  2

  N/A

• 1.5 Is the F10 displayed with relevant parties indicated?

  0

  1

  2

  N/A

• 1.6 Is there an Emergency plan displayed?

  0

  1

  2

  N/A

• 1.7 Are the site rules present & displayed?

  0

  1

  2

  N/A

• 1.8 Is a fire extinguisher present and in date?

  0

  1

  2

  N/A

• 1.9 Is a first aid box present including eye wash?

  0

  1

  2

  N/A

• 1.10 Is an accident book present?

  0

  1

  2

  N/A

• 1.11 Has a 1st Aider been identified

  0

  1

  2

  N/A

• Additional information

2. Documentation

• 2.1 Pre-construction Phase Plan

  0

  1

  2

  N/A

• 2.2 Construction Phase Plan

  0

  1

  2

  N/A

• 2.4 SIS RAMS for current work activities - Briefed and signed

  0

  1

  2

  N/A

• 2.5 Construction Drawings

  0

  1

  2

  N/A

• 2.6 Traffic Management<br> Drawings

  0

  1

  2

  N/A

• 2.7 Accreditations / Safety Passports

  0

  1

  2

  N/A

• 2.8 Site Induction - Briefed and signed

  0

  1

  2

  N/A

• 2.9 Utility drawings

  0

  1

  2

  N/A

• 2.10 Are emergency plans in place for ALL possible hazardous situations?

  0

  1

  2

  N/A

• 2.11 Temporary Work Flow Chart

  0

  1

  2

  N/A

• 2.14 Correspondence for the project

  0

  1

  2

  N/A

• Additional information

3. Yard

• 3.1 PPE worn in accordance with RAMS

  0

  1

  2

  N/A

• 3.2 Signage

  0

  1

  2

  N/A

• 3.3 Has the Fire Assembly Point been identified?

  0

  1

  2

  N/A

• 3.4 Gas Storage

  0

  1

  2

  N/A

• 3.5 Cable Storage

  0

  1

  2

  N/A

• 3.6 COSHH Storage

  0

  1

  2

  N/A

• 3.7 Spill Kits

  0

  1

  2

  N/A

• 3.8 Drip trays

  0

  1

  2

  N/A

• 3.9 Fuel bowser

  0

  1

  2

  N/A

• Additional information

4. Site Management

• 4.1 Planning/Organisation of project

  0

  1

  2

  N/A

• 4.2 PPE worn in accordance with RAMS

  0

  1

  2

  N/A

• 4.4 Barriers checks

  0

  1

  2

  N/A

• 4.6 Secured storage area for equipment and materials

  0

  1

  2

  N/A

• 4.9 Spill kits

  0

  1

  2

  N/A

• 4.10 Drip trays

  0

  1

  2

  N/A

• 4.11 Fire extinguisher (present & in date)

  0

  1

  2

  N/A

• 4.12 First aid kit

  0

  1

  2

  N/A

• Additional information

5. Overall

• 5.1 General housekeeping

  0

  1

  2

  N/A

• 5.2 Does site manager and team leader portray correct attitude and understanding towards safety, quality & environmental aspects of the project

  0

  1

  2

  N/A

• Additional information

• CAT 1 (0% > 49%)

• Immediate Rectification Required to comply with CDM Regulations 2007

• CAT 2 (50% > 74%)

• Rectification required within 24hrs

• CAT 3 (75% > 94%)

• Rectification required within 7 working days

• CAT 4 (95% > 100%)

• Good overall audit - Please rectify defects ASAP

• Signature

  Sign