Title Page

  • Site Address:

  • Licensed Contractor and Address:

  • Auditor:

  • Report Reviewed By:

  • Report Revision Number

  • Audit Start Time:

  • Audit Finish Time:

  • Report Issue Date:

1.0 Preliminaries

  • 1.1 - Supervisors Details

  • 1.2 - No. of operatives on site

  • 1.3 - Scope of work

2.0 Welfare

  • 2.1 - Do site personnel have access to toilet facilities on site?

  • 2.2 - Is hot & cold running water available on site?

  • 2.3 - Are soap or washing agents available?

  • 2.4 - Is a means of drying hands available?

  • 2.5 - Is a rest area (seating) available on site?

  • 2.6 - Is there a means of heating food or drinks?

  • 2.7 - Where is the first aid box located?

  • 2.8 - Is there a trained first aider on site?

  • 2.9 - Are any fire extinguishers available on site and are they the correct type?

  • 2.10 - Where is the muster point, is signage in place, is it on the site plan?

  • 2.0 Site Documentation

3.0 Site Documentation

  • 3.1 - Is a copy of the contractors HSE Licence available?

  • 3.2 - Is a copy of the ASB5 available?

  • 3.3 - Is a copy of the contractors Public Liability Insurance Certificate available?

  • 3.4 - Is a copy of the contractors H&S policy/ Manual available?

  • 3.5 - Is a copy of the contractors Plan of Work available?

  • 3.6 - Is the correct Supervisor named on the ASB5? (give details)

  • 3.7 - Do the hours of work and dates match the ASB5?

  • 3.8 - Has POW been signed by all persons on site?

  • 3.9 – Does site set up match the sketch plan in the POW?

  • 3.10 - Is the Scope of Work clearly defined?

  • 3.11 - Are the air management calculations correct?

  • 3.12 - Have any amendments been made to the POW and recorded?

  • 3.13 - Are risk assessments available and site specific?

  • 3.14 - Are COSHH assessments available and site specific?

  • 3.15 - Is the site log/diary up to date? (Time of last entry)

  • 3.16 - Have daily mask checks been completed and recorded?

  • 3.17 - Has the daily DCU inspection been completed and recorded?

  • 3.18 - Has the enclosure inspection been completed and recorded?

  • 3.19 - Is the enclosure smoke test record available?

  • 4.0 Plant / Certification

4.0 Plant / Certification

  • 4.1- Are an adequate number of H vacs on site?

  • 4.2 –Are test certificates, held on site, valid and relevant to equipment on site?

  • 4.3 – Is the equipment on site in good condition/ well maintained?

  • 4.4 - Does the equipment have in date PAT stickers applied?

5.0 Enclosure / airlock / Baglock

  • 5.1 - Is the enclosure adequately supported?

  • 5.2 – Is the enclosure in sound condition to prevent the spread of asbestos?

  • 5.3 - Is the enclosure constructed with 1000 gauge polythene (fire retardant / standard)?

  • 5.4 - Does each stage of the airlock system comply with current practice (2m³ per stage)?

  • 5.5 - Do the airlock openings introduce trip hazards?

  • 5.6 - Are all airlock flaps on the inside (enclosure side)?

  • 5.7 - Do the flaps adequately cover the airlock opening?

  • 5.8 - Are all flaps weighted?

  • 5.9 – Does the vision panel meet the necessary criteria (min 600x300 on dirty stage of airlock)?

  • 5.10 – Do vision panels or CCTV give full visibility inside the enclosure?

  • 5.11 – Are a bucket and sponge (or similar) present for primary decontamination?

  • 5.12 – Is a H vac available for vaccing off?

  • 5.13 – Is there adequate signage in place on the enclosure?

  • 5.14 - Are the works sufficiently segregated from others ( fencing, hoarding, barriers, tape)?

  • 5.15 - Is adequate signage in place for transit / waste routes?

6.0 Air Management

  • 6.1 – Is the extract equipment sited to give ideal air management?

  • 6.2 – Is the extract equipment capable of giving the minimum of 8 air changes per hour?

  • 6.3 – Is the extraction vented to the outside?

  • 6.4 – Is the exhaust hose in good condition?

  • 6.5 – Does the capacity of NPU(s) match the Plan of Work?

  • 6.6 – Are NPU certificates valid and relevant to equipment on site?

7.0 Suppression / Removal Technique

  • 7.1 – Is the dust suppression method as indicated within the POW?

  • 7.2 – Is the dust suppression technique suitable for the type of material?

  • 7.3 – Have exposure limits been determined and checked?

  • 7.4 – Is the removal method as per the POW and is best practice being observed?

8.0 PPE / RPE

  • 8.1 – Are the RPE and filters being used as per the POW?

  • 8.2 – Are the colours of coveralls as per the POW?

  • 8.3 – Is all other required PPE present (eye protection, hard hat, gloves) to mitigate hazards on site?

9.0 DCU

  • 9.1 - Does the unit comply with the requirements of HSG247?

  • 9.2 - Is the unit connected to work area (If no, was it possible to connect to the work area)?

  • 9.3 - Is the transit route as short as possible and away from occupied areas?

  • 9.4 - Is the unit connected and in good working order (water/ electrics/ drainage)?

  • 9.5 - Is the unit connected to an RCD unit and earthed?

  • 9.6 - Is the DCU NPU certificate available?

  • 9.7 - Is the DCU boiler test certificate available?

  • 9.8 - Is the DCU electrical test certificate available?

  • 9.9 - Is the DCU air test certificate available? (Date of most recent test)

  • 9.10 - Is there a carbon monoxide detector fitted?

  • 9.11 – Are an adequate number of shower heads available for number of personnel on site? (1:4)

  • 9.12 – Are a nailbrush and shower gel available?

  • 9.13 – Is the unit clean as far as reasonably practicable?

  • 9.14 – Is the waste water discharged to a foul drain?

  • 9.15 – Is the filter on the waste water clean/ has it been changed recently?

10.0 waste

  • 10.1 – Are UN approved packages being used?

  • 10.2 – Is the waste route clear of waste and other debris?

  • 10.3 – Is a baglock being used?

  • 10.4 – Is a skip present (if so, is it locked and in good condition)?

  • 10.5 – If waste is being transferred in the van is the bulkhead sealed?

11.0 Air Monitoring

  • 11.1 – Are the details of analytical company stated within the POW?

  • 11.2 – Background Testing

  • 11.3 – Leak Testing

  • 11.4 – Reassurance testing

  • 11.5 – Personal Monitoring

  • 11.6 – 4 Stage Clearance

12.0 Access Equipment

  • 12.1 - What access method is being used?

  • 12.2 - Is the access equipment in good condition?

  • 12.3 - Does the access equipment have a unique identification number or reference?

  • 12.4 - Has the access equipment been inspected and recorded?

  • 12.5 - If mobile towers are being used, are the site personnel PASMA trained?

  • 12.6 - If MEWPS are being used, are site personnel IPAF trained?

  • 12.7 - If a fixed scaffold is being used, is a scaff tag or inspection record available, is the last inspection within 7 days?

  • 13.0 Site Personnel
  • 13.1 - Name

  • 13.2 - Job Title

  • 13.3 - Clean shaven

  • 13.4 - Valid medical

  • 13.5 - Valid face fit test - Half Mask

  • 13.6 - Valid face fit test - Full Face Mask

  • 13.7 - Service certificate for Full Face Mask available

  • 13.7 - Valid training certification

14.0 Comments and Recommendations for Action to be Taken

  • Action Point / Observation

  • Action Point / Observation

  • Action Point / Observation

  • Action Point / Observation

  • Action Point / Observation

Audit Summary

  • undefined

Audit Sign Off

  • Supervisor name

  • Supervisor signature

  • Date

  • Auditor name

  • Auditor signature

  • Date

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.