Title Page

  • Conducted on

  • Prepared by

  • Location

PSCS & Main Contractor

  • Company is the main contractor?

  • Method Statements with Hazard & Risk Assessments prepared?

  • Scaffolding examined and recorded in register (GA3)?

  • Excavations examined and recorded in register (AF3)?

  • Lifting appliances examined weekly and recorded in register (GA2)?

  • Current examination certificates for cranes, forklifts, excavator, MEWP, chains, slings, shackles, etc. (GA1)?

  • Are hot works being carried out safely?

  • Are Permits being implemented?

  • Are Task Specific Risk Assessments being performed?

  • AF1& AF2 posted on-site?

  • Company 'Blue Pack' on-site?

  • Site personnel inducted?

  • Site personnel signing Site Register?

  • All emergency access / egress routes unobstructed?

  • Adequate number of fire extinguishers present on-site?

  • Material stored appropriately in site compound?

Sub-Contractors

  • Method statements with hazard & risk assessments received?

  • Plant & Machinery certification received?

  • Training certification received, Safe Pass, Manual Handling, CSCS etc.

1. Site set up

  • Are site facilities adequate?

  • First Aid & Assembly Point Signs posted?

  • Any issues with Contractor parking?

2. PUBLIC SAFETY AND SIGNS

  • Fencing securely erected / maintained?

  • Signs adequate for public safety?

  • Public protected from site activities?

3. WORKPLACE & ACCESS WALKWAYS

  • Is there safe access & egress to all working areas of the site?

  • Are access routes adequately lit?

4. PERSONAL PROTECTIVE EQUIPMENT

  • Full PPE compliance onsite?

5. HOUSEKEEPING

  • Work areas neat & tidy?

  • Debris & waste removed regularly to site skip?

  • Is site skip full?

  • Nails removed & protruding rebar, etc. protected?

  • 6. DEMOLITION / REFURBISHMENT

  • Hazards of asbestos, red lead, PCB, identified?

  • Method statement / surveys available?

  • Have all services been disconnected / isolated?

  • Are Exclusion Zones established?

  • Suitable dust superssion in place / personnel wearing dust masks?

  • Is there suitable lighting?

  • Is material being removed from site on a regular basis?

  • 7. WORKING AT HEIGHTS

  • Adequate access provided to place of work?

  • Roof edges protected?

  • Ladders used correctly and in good condition?

  • Work equipment register in use – weekly inspection of all equipment – pre use check?

  • All Ladders on-site in good order & form GA3 completed

  • Are Mobile Towers erected correctly & Form GA3 completed?

  • MEWP's certified and inspected on Form GA3?

  • Personnel wearing harnesses, suitable lanyard & tied off to correct anchor point?

  • 8. SCAFFOLDING

  • Scaffold erection, alteration or dismantling is carried out by a competent person?

  • Is Scaffolding on sound footing?

  • Are Handrails & mid rails in place?

  • Toe boards in place?

  • Is scaffolding adequately tied to structure?

  • Are platforms fully boarded and all boards in good order?

  • Is housekeeping in good order (i.e. no trip hazards, muck etc) present on boards

  • Is material suitable stored on the scaffold?

  • Is scaffold tagged, Form GA3 complete & signage in place?

  • Are trestles suitable erected and maintained?

  • 9. PLANT & MACHINERY

  • Is Plant & Machinery certified

  • Has Form GA2 been completed for all Plant & Machinery?

  • Is all Plant & Machinery without defects?

  • Personnel operating Plant & Machinery CSCS trained?

  • 10. EXCAVATIONS

  • Have any underground services been highlighted?

  • Is DFL permit to dig & Form A3 completed?

  • Is there safe access into the excavation?

  • Are the banks suitably sloped / stepped?

  • Is there an exclusion zone & signage posted around excavation?

  • Is material stored a safe distance from the edge of the excavation?

  • 11. LIFTING OPERATIONS / EQUIPMENT

  • Is a lift plan in place and signed by all responsible persons?

  • Is lifting equipment certified?

  • Has the lifting equipment been inspected and recorded on Form GA2?

  • Are loads being slung and guided by CSCS trained personnel?

  • Is there an exclusion zone set up around the lifting operation?

12. HAND TOOLS / POWER TOOLS

  • Tools in good condition?

  • Safety Guards in place where required?

13. ELECTRICAL & MECHANICAL SAFETY

  • Lock Out / Tag Out permit completed where necessary?

  • 110v system used?

  • Are all cables & leads in good order?

  • Transformers in good condition?

  • No trailing leads present?

  • Suitable & sufficient task specific lighting provided

  • Electrical panels closed with signage in place?

  • Overhead lines protected?

  • 14. BURNING AND WELDING

  • Is hot works permit in place?

  • Equipment in good repair?

  • Bottle trolley provided?

  • Firefighting equipment present?

  • Good ventilation or protection?

  • Shields / Goggles and screen used?

15. ENVIRONMENTAL

  • Diesel Tank contained?

  • Dust / Noise control?

  • Hazardous substances identified & handled appropriately?

  • Waste disposal in place?

  • Existing drains / gully's protected from work activities?

  • Drip trays in place where required?

  • Plant & Equipment in good order & free from leaks?

  • 16. COMPRESSED AIR

  • Pressure vessel Test Cert (26 month) Available?

  • 17. CONFINED SPACE

  • Risks identified prior to Entry?

  • All Control measures in place?

  • Confined Space permit completed?

  • Personnel Trained in Confined Space Entry?

  • All suitable PPE worn?

  • All personnel aware of emergency procedures?

  • 18. TRAFFIC MANAGEMENT

  • Has a traffic management plan been prepared?

  • All signage erected as per Chapter 8, DoT, Traffic Sign Manual?

  • Additional/ Other

  • Item

  • Additional
  • Details

  • Compliance

  • Safety Adviser

  • Site Manager

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.