Title Page

  • Site Name

  • Conducted on

  • Prepared by

  • Location
  • Project Reference

  • Weather Conditions

  • Principal Contractor

Security & Public Safety

  • Unauthorised access to site prevented

  • Site Induction & Security briefing delivered to site workers

  • Warning sites in place e.g. no trespassing, hard hat area

  • Site sign in/out book appropriately used

  • Contractors on site hold appropriate identification

  • Work area appropriately segregated from the public

  • Adequate lighting for both site and public

Housekeeping

  • Exits and access routes maintained and unobstructed

  • Machinery and vehicle access points to public highways are clean and clear

  • Waste bins are appropriate for the work undertaken with consideration to the hierarchy of waste and are being used in accordance with local instruction (no contamination)

  • Waste is being taken away by a licenced waste carrier and is treated/disposed of at a licenced premises

  • Waste bins are enclosed

  • Arrangements are in place to keep the site and surrounding area clear of litter produced by the works

  • Materials stored correctly when not in use

  • Site free from unnecessary slip, trip, fall hazards

  • Arrangements in place to clean vehicles where needed

  • Adequate drainage and/or pumping systems in place to remove build-up of surface water

  • No smoking taking place on site

PPE

  • Correct PPE being used on site

  • PPE in good condition e.g. not torn, hi-viz appropriate

  • Appropriate storage for PPE

  • Site workers aware of PPE requirements

  • Evidence that PPE requirements are being enforced

Electrical Works

  • Site workers competent in the use of electrical equipment

  • No overloaded electrical sockets on site

  • Electrical equipment in good condition e.g. no frayed cable

  • Electrical isolations in place where necessary

  • 110volt dc equipment being used where possible

  • Special permits in place for work within 2.75m of OLE

  • Adequate PAT on portable electrical equipment

  • Lock Out/Tag Out programme in place

Scaffolding

  • Erection properly supervised

  • Guard rails, intermediate rails and toeboards in place

  • Scaffolds erected on solid footing with secure connections

  • Protection from falling objects in place

  • Scaffold tied to a structure

  • Fall protection equipment available and in use

Hazardous/Dangerous Substances & Explosive Atmospheres

  • COSHH assessments in place and being followed

  • Health surveillance completed (if required)

  • Appropriate storage arrangements in place for chemicals

  • Appropriate ventilation in place where required

  • No explosive materials stored on site

  • Spills kits adequate and available where required

  • Fuels and other oil based substances are stored on/within bunding

Platform Works

  • No work carried out within 1.25m of the platform edge

  • No work carried out within 2.75m of the OLE

  • No risk to customers from platform works e.g. plant/fumes

Fire

  • All staff have received the fire safety brief

  • Appropriate firefighting equipment is available on site

  • Emergency exit routes from site are free from obstruction

  • Potential hazardous run-off from a fire has been considered and controls put in place where needed

  • Smoking only in designated areas

Height Access

  • Ladders inspected daily (request evidence)

  • Ladders not left unattended

  • No damaged ladders in use

  • Ladders at a 1:4 pitch

  • Ladders anchored/tied off and extend 3feet above landing

  • Crawling boards are used on fragile roofs

  • Areas under the work at height are cordoned off

  • Competent workers using height access equipment

  • Height access equipment appropriately inspected

  • Fall protection equipment available and in use

Excavations and Confined Spaces

  • All excavations are guarded

  • All excavations are appropriately supported

  • Appropriate measures in place for confined space entry

  • Breathing apparatus provided & used for confined spaces

  • Adequate confined space entry training for workers

Lifting Equipment

  • Qualified operators using lifting equipment

  • Equipment subject to appropriate regular inspections

  • Loads not being lifted where, if dropped, could cause harm

  • Equipment locked out/inaccessible when not in use

Asbestos

  • R&D Surveys have been completed where required

  • Asbestos management survey is readily available on site

Welfare

  • Adequate toilet facilities on site

  • Adequate hand washing facilities with hot and cold water

  • Adequate mess facilities separate from work site

  • Drinking water provided on site

First Aid

  • Adequate number of trained first aiders on site

  • First aid arrangements communicated to site workers

  • First aid kit available and properly stocked

Documentation (to include, where applicable, signatures of workers and be readily available to inspector)

  • F10 available and in date

  • CPP available and approved

  • Pre-start safety meeting

  • RAMS available on site

  • Any required permits to work e.g. for hot works

  • Emergency procedures

  • Training certificates

  • Safety Critical medical notification

  • Equipment inspection certificates

Energy

  • Contractors are supplying their own energy – unless prior agreement has been sought with Northern

  • Equipment, lights and heating are been turned off when not required where feasible to do so.

Nuisance

  • Local instruction in place to ensure machinery, mechanical and personnel noise is kept to a minimum; check arrangements are in place where needed and instructions are being followed.

  • Lighting is appropriate and not intruding on residential properties.

  • Adequate measures are in place to minimise and eliminate vibration on properties and areas used by residents and the public

  • Adequate arrangements are in place to minimise / eliminate the production of dusts and fumes passing the site boundary

Bio-diversity

  • Work is not being undertaken in areas impacting upon nesting birds.

  • Any protected species i.e. bats, badgers and other protected species have been identified and adequate arrangements are in place for their protection and being adhered to

Sign Off

  • Name of Site Lead

  • Signature of Site Lead

  • Signature of Inspector

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.