Title Page

  • Conducted on

  • Prepared by

  • Location
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  • Inspected By

  • Project

  • Site

  • Site

  • Project

1. Site Documentation

  • 1.1 Construction Phase Plan

  • 1.2 Health & Safety Policy

  • 1.3 F10

  • 1.4 Emergency Contact List

  • 1.5 Insurance

  • 1.6 Law Poster

  • 1.7 Risk Assessments

  • 1.8 WPP / TB / MS

  • 1.9 Permits (hot works, dig, C Form...)

  • 1.10 Inspection Registers (Statutory Registers)

  • 1.11 Subcontractor Documentation

  • Comments or Nil Return:

2. Monitoring

  • 2.1 Fire Control

  • 2.2 First Aid

  • 2.3 Toolbox Talks

  • 2.4 Welfare Facilities

  • 2.5 Competence

  • 2.6 Induction

  • Comments or Nil Return:

3. Railway Related Specifics

  • 3.1 SSOW (Briefing, Protection Arrangements, Signed off...etc)

  • 3.2 Sentinel Checks (Validity, Sponsor, Competence...)

  • 3.3 WPP / TB (Briefing, Compliance..)

  • 3.4 Access Points

  • 3.5 COSS Performance (Briefing, Work Group Control...)

  • 3.6 ES Performance (COSS Briefing...)

  • 3.7 OLE / OTP / ALO / CC – MC

  • 3.8 Emergency Arrangements

  • 3.9 Life Saving Rules (Communication, Compliance...)

  • Comments or Nil Return:

4. Work Task Performance

  • 4.1 PPE (Compliance)

  • 4.2 Work at Height (Access, Falls, Edge Protection...)

  • 4.3 Housekeeping

  • 4.4 COSHH (Hazardous / Flammable Substances)

  • 4.5 Security

  • 4.6 Buried / Overhead Services

  • 4.7 Signage

  • 4.8 Electricity (PA Test, Trailing Leads...)

  • 4.9 Work Platforms (Towers, Scaffolds, MEWP's...)

  • 4.10 Noise / Vibration (Safe Use, Assessment...)

  • 4.11 Excavations (Guarded, Exclusion Zones, Inspected...)

  • 4.12 Access & Egress Routes (Signed, Clear of Obstruction...)

  • 4.13 Asbestos (Register, Survey, Training...)

  • 4.14 Manual Handling (Assessment, Technique...)

  • 4.15 Abrasive Wheels (Safe Use, PPE, Training...)

  • 4.16 LOLER / Lifting (RAMS, Lift Plan, Inspection, TE, Competency...)

  • 4.17 Confined Spaces (Permits, RAMS, Competency...)

  • 4.18 Plant / Equipment (PUWER...)

  • 4.19 Other - State: Foul weather clothing

  • Comments or Nil Return:

5. Environmental / Ecology

  • 5.1 WPP / TB / MS (Reference to Environment / Ecological Performance)

  • 5.2 Waste (In Accordance with WPP / TB / MS, Segregation, Skip ID...)

  • 5.3 Ecology (Briefings, Habitats, Surveys...)

  • Comments or Nil Return:

6. Management / Supervision

  • 6.1 Is management structure clearly defined and understood?

  • 6.2 Is a management organogram displayed?

  • 6.3 Are on-site management meetings held and attended?

  • 6.4 Are statutory registers completed and supervisor inspections carried-out weekly?

  • Comments or Nil Return:

7. Surveillance

  • 7.1 Does member of staff have the necessary competencies to work on the equipment in their area?

  • 7.2 Has all new work been carried-out / completed to the requirements of the appropriate standards?

  • 7.3 Have the correct tools / equipment been used to undertake the work?

  • 7.4 Have all the records been completed and signed off correctly?

  • Comments or Nil Return:

  • Additional Comments

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.