Title Page
-
Site conducted
-
CDM REPORT NO
-
Project
-
Project No
-
Conducted on
-
Site Manager
-
Site Inspector
-
Address
01 Documentation
F10
-
Visible
-
Dates
-
Signed
Insurances
-
Public
-
Employer
Contractors MS/RA
-
On Site
-
Approved
-
Operation
Site Register
-
On Site
-
Being Used
-
Spare Pages
Induction Book
-
On Site
-
Being Used
Site H&S File
-
Inspections
-
Accidents
-
Permits
02 Security
External
-
Stores & Materials
-
Compound
-
Site Entrance
Internal
-
Building Manager
-
Internal Security
-
External Security
03 PPE
-
Operatives
- Safety Boots
- Hard Hats
- Hi Viz
-
Visitors / Spare
- Safety Boots
- Hard Hats
- Hi Viz
-
Inspection Checks
04 Protection including others
-
General Public
-
Building Staff
- Carpet protection
- Staff protection
- Asset Protection
- Other
-
Specify
05 Access / Egress
-
Site Entrance
-
Compound Entrance
-
Escape Routes
06 Signage
General
-
Details
First Aid
-
First Aider Named
-
Location of Box
-
General
Warning
-
Details
Mandatory
-
Hard Hats
-
Hi Viz
-
Safety Boots
-
Noise
-
Permits
-
Other
Danger & Prohibition
-
Details
Other
-
Deliveries
-
Marketing Board
-
Site Office
07 Fire Routes & Precautions
Routes
-
Fire Routes & Precautions
-
Routes
-
Temporary Direction
-
Permanent Direction
-
Crown Fire Plan
Extinguishers
-
Foam
-
CO2
-
Water
-
Powder
-
In Date
-
Test Certificate
-
Meter Green
-
Weighed (CO2)
Warning
-
Details
08 Site Management
-
Project Manager
-
Site Manager
-
Site Foreman
09 First Aid
First Aider
-
Name
-
Qualification
-
Sticker
Box Location
-
In office
Adequate Resource
-
Plasters
-
Eye Pads
-
Bandages
-
Dressings
-
Gloves
-
Wipes
10 Emergency Procedures
Fire
-
Building Procedures
-
company Procedures
-
Fire alarm deactivated
-
Air horn in use on site
Medical Assistance
-
Details
Other
-
Terrorist threat
-
COMAH
-
Environmental
11 Accidents
-
HSE data compliant book
-
Accident investigations
-
Accidents reported
-
RIDDOR 2508
12 Materials Storage
Internal
-
Safely Stored
-
Segregation
-
COSHH
External
-
Safely Stored
-
Segregation
-
COSHH
13 Electricity
-
Lighting
-
Power tools
-
Transformers
-
Pat Tested
-
RCD Used
-
110v / 240v
14 Housekeeping
-
Generally
-
Specific
15 Hazardous Materials
-
Known Asbestos Sample<br>
-
Asbestos Survey Type
-
Type 1
-
Type 2
-
Type 3
-
Lime based products
-
Specify Other
-
Chemical/Gaseous
-
Specify Other
-
COSHH Risk Assessment and Safety Data Sheet contained in Site Health & Safety File
16 Working at Height/ Scaffolding
- SA1 Scaffold Erections
-
Basic Description
-
Location
-
Scaff Tag
-
Single Report
-
Result
-
Hazards Identified
SA2 Mobile Access Towers
-
Location
-
Type
-
Result
-
Hazards Identified
SA3 Stepladders
-
Location
-
Type
-
Result
-
Hazards Identified
-
Health and safety Issues identified from work at height inspections
17 Excavations
-
Trenches
-
Holes
-
Other
18 Manual Handling
-
Select
-
Details
19 Demolition
-
Details
20 Welfare Facilities
-
Select
21 Confined Spaces
-
Select
22 Permit to Work
-
Select
-
Specify
23 Noise
-
Noise metre on site
-
Client noise levels agreed
-
Time restrictions
-
1st Action Level 80db
-
2nd Action Level 85db
-
Peak Action Level 200pcl
24 Welding, Brazing and Gas Cutting
-
Select
-
Specify
-
Specify
25 Plant and Machinery
-
Cherry Picker
-
Status
-
MEWP
-
Status
-
Telehandler
-
Status
-
Other
-
Status
26 Environmental and Waste Disposal
-
Asbestos Disposal Required
-
Asbestos Removal Clean Air Cert Inspected
-
Use of Skips for Construction Debris
-
Gypsum Content of Plasterboards Deemed as Controlled WR
-
General Discharge of Effluents into Controlled Water Sources
-
OTHER ENVIRONMENTAL CONCERNS
27 Health and Safety Manager’s Follow up Actions
- ACTIONS
-
Details
Additional Detailed Report
-
1 To be rectified within 24 hours.
-
2 To be rectified within 3 days.
-
3 To be rectified within 7 days.
-
4 To be rectified when practical.
-
All the items listed in red are for the remedial attention of the site manager and are based on the health and safety manager’s observations at the time of the inspection. If items are displayed in red, the site manager is to speak to the H&S manager on guidance to allow for rectification of the problem.
-
ARE THE SITE H&S MEETINGS BEING CONDUCTED?
-
ARE TOOLBOX TALKS BEING GIVEN?
-
ARE IDENTIFIED HAZARDS BEING RECTIFIED?
-
This report includes the mandatory inspection of working platforms above two metres (section 16) and must be held on site in the site H&S file. These reports will be held electronically for a period not less than 3 months as required by the work at height regulations 2005.
-
I confirm that all items and observations made on this report are accurate and have been made at the time stipulated on the report.
-
Date and time of Inspection
-
Site Manager Present
-
Name and Signature of Auditor
-
Position
-
Time of Section 16 Inspection
