Title Page
-
Date and Time
-
Site Name
-
Location
-
Client
-
Consultant
-
Contract Manager
-
Site Manager
Inspection Completion
-
Consultant Signature
-
Accepted by Name
-
Accepted by Signature
-
Accepted by Role
Personnel and Task Summary
-
Personnel
-
Summary of Tasks
- WAH
- MHO
- Excavations
- Earth Works
- Traffic Managment
- Access Equipment
- Plant
- Rail
- Confined Space
- Live Traffic
- Tenanted Properties
- Waste Handling
- Asbestos Recovery
- Roads/Street Works
Previous Findings
-
Previous Report Closed Out
-
Which items are still outstanding?
Further Notes and Findings
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Summary Comments
Organisation and Management
-
Adequate Management
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Adequate Supervision
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Organisation
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Leadership Tours & Visits
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Working Hours & Travel
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
Engagement
-
Team Briefings
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Toolbox Talks
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
HSEQ Meetings
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Daily Activity Brief
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Notice Boards
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
Documentation
-
Statutory Notices
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
HSQE Plans (CPP)
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Inductions
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Site Rules
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Permits to Work
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Fire Risk Assessment
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Traffic Management
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Fire Evacuation Plan
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Lift Plans
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
RAMS
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Certificates of Thorough Examination
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Calibration
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
Competence
-
Competent Advice
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
CPCS
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Asbestos Training
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
SMSTS/SSSTS
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Fire Warden/Management
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
First Aiders
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Manual Handling
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Working at Height
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Street Works (Chapter 8)
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Temporary Works
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Other Competences (Specify)
Welfare
-
Safe Route of Access
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Lighting
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Heating Food
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Food Storage
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Fresh Water
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Lockers
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Washing Facilities
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Resting Facilities
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Cleanliness
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Toilets and Provisions
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
Workplace
-
Site Layout
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Signs and Signals
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Pedestrian Safety
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Security
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Housekeeping
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Underfoot Conditions
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Vulnerable People
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Lone Workers
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
Safety
-
Working at Height
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Access Equipment (Tower/Podium etc.)
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Edge Protection
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Exclusion zones
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Tools & Equipment
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Lifting Ops/Equipment
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Fire Equipment
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
First Aid
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Gases
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Electricity
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Guarding/Safety Controls
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Temporary Works
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
PPE
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
Health
-
Medical questionnaire
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Biological Hazards
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Drugs and Alcohol
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Dust
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
DSE
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Vibration
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Noise
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
Emergencies
-
Accidents & Incidents
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Tests & Drills
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
Behaviours
-
Leadership Standards
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Workforce Behaviours
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Attitude to Respect
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Attitude to Rules
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Attitude to Intervention
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
Environment
-
Risk Identification
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Carbon & Energy
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Natural Resource Use
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Nuisance Management
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Pollution Prevention
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Waste Containers / Labelling
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Waste Separation
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Waste Transfer/Consignment notes
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Environmental permit
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Nuisance/permit monitoring
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
Quality
-
Design Management
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Inspection & Test Plans
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Materials Handling/ Storage
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Subcontractor Control
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Subcontractor Review
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice
-
Workmanship Standards
- Good
- Fair
- Poor
- N/A
- Not Checked
- Good Practice