Title Page

  • Client:

  • Report No.:

  • Date:

  • Prepared by

  • Consultant:

  • Ground Works Supervisor:

  • Address:
  • Contracts Manager

  • Number Of Operatives on site

  • Activities carried out while on site

DOCUMENTATION

  • RAMS ) safety folder available and signed?

  • COSHH assessments on site/in date?

  • Lifting Gear tagged and Certificates available?

  • Permit Systems being completed?

  • Sign in register completed?

  • Toolbox Talks being carried out?

  • C.A.T calibration certs available?

  • Plant checklists for types of plant available?

  • Plant Risk assessment completed?

  • Hired Ops Induction Complete?

  • Small Plant/Lifting accessory register complete?

  • Small plant safe to use?

MOBILE PLANT

  • Trained operators

  • Seat belts/interlock system/flashing beacons activated

  • Safe operation

  • Thumbs up signs fitted?

  • Keep compartment locked warning sticker fitted?

  • Thorough exams in available?

  • Pre-use checks carried out?

  • Faults reported?

  • Keys removed from plant?

  • Safety critical Features fitted/working?

EXCAVATIONS

  • Excavation safe to enter?

  • Service tracks/Holes safe?

  • Safe access to excavation provided?

  • Shoring in place/required?

  • Edges protected?

  • Excavation register completed?

  • Water management in place/maintained?

PPE

  • Standard PPE worn?

  • Hearing protection?

  • Eye protection?

  • Respiratory protection?

GENERAL SITE SAFETY

  • Safe access/egress Provided to work areas?

  • Public safety?

  • Occupied areas safe?

  • Material storage safe/tidy?

  • Housekeeping regime in place?

  • Adequate plant segregation/traffic management?

  • Working at height controls in place?

  • Ladders ( safe to use) ? securely footed?

  • Fire risk controls in place?

  • First aid cover provided?

  • Live services safe system of work being followed?

  • Working Close to Overhead Powerlines SSoW being followed?

OPERATIVES

  • Working safely?

  • Competent/trained?

  • Hand/arm vibration?

  • Manual handling?

WELFARE

  • Running hot/cold water?

  • Soap/hand towels?

  • No of toilets adequate?

  • Drying room adequate?

  • Welfare Facilities Covid secure?

ENVIRONMENTAL

  • Fuel secured?

  • Spill kits in place/drip trays in place?

  • Surface water management plan in place/maintained

CONFINED SPACES

  • Permit to enter completed

  • Confined space SSoW being followed?

  • Entry/rescue equipment on site/being used?

  • Trained persons?

Lifting Operations

  • Lift plans available/completed?

  • Trained/competent operatives?

  • Lifts being carried out safely?

Supervision/Management

  • Supervision/Management adequate for task?

  • Supervision/management in place?

Miscellaneous

Signature page

  • Add signature

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.