Title Page

  • Job No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Conducted by

  • Location
  • Personnel

1 General Documentation

1 General Documentation

  • 1.1 Method Statement

  • 1.2 Work Package Plan / Task Briefing

  • 1.3 Risk Assessment

  • 1.4 COSHH Assessments

  • 1.5 Emergency Procedures

  • 1.6 MS/WPP/TB Brief

  • 1.7 SSOW Information

  • 1.8 Notice Board

2 Site Safety

2 Site Safety

  • 2.1 Fire Precautions

  • 2.2 Access/Egress

  • 2.3 First Aid

  • 2.4 Designated Hospital Identified

  • 2.5 Competence

  • 2.6 Storage and Materials

  • 2.7 Tidiness

  • 2.8 Lighting

  • 2.9 Barriers

  • 2.10 Traffic/Pedestrian Routes

  • 2.11 Excavations

3 PPE

3 PPE (correctly identified, used and maintained)

  • 3.1 Hard Hats (5 Year Life Span)

  • 3.2 Ear Defenders

  • 3.3 Safety Boots

  • 3.4 Wet Gear

  • 3.5 Gloves

  • 3.6 Goggles/Glasses

  • 3.7 Chainsaw Clothing

  • 3.8 Climbing Equipment

  • 3.9 Hi-Viz Jackets/Vests

  • 3.10 Any Other (please specify)

4 Plant Safety

4 Plant Safety

  • 4.1 Machine Certificates

  • 4.2 Operator Certficates

  • 4.3 Cat Scan

  • 4.4 Services Marked

  • 4.5 Permit to Dig

  • 4.6 Lifting Equipment

  • 4.7 Operation

  • 4.8 Banksmen/Slingers

  • 4.9 Cranes Set Up

  • 4.10 Abrasive Wheels

  • 4.11 Guards/Lights/Horns

5 Hazardous Substances

5 Hazardous Substances

  • 5.1 Asbestos

  • 5.2 Lead

  • 5.3 Other (please specify)

6 Protecting The Public

6 Protecting The Public

  • 6.1 Site Fencing

  • 6.2 Footpaths

  • 6.3 Traffic Management

  • 6.4 Site Security

  • 6.5 Warning Signs

7 Working Platforms

7 Working Platforms

  • 7.1 Scaffolding

  • 7.2 Mobile Towers

  • 7.3 M.E.W.P's

  • 7.4 Ladders

  • 7.5 Competence

  • 7.6 Inspection/Handover

8 Railway SSOW

8 Railway SSOW

  • 8.1 SSOW Briefing

  • 8.2 Briefing Arrangements (COSS/MC)

  • 8.3 Certification - PTS etc

  • 8.4 Fencing

  • 8.5 Lookout Risk Assessment

  • 8.6 Lookouts/SW (inc. Equipment)

  • 8.7 Line Speed & Sighting

  • 8.8 Place of Safety

  • 8.9 Blocking Arrangements

9 Environment

9 Environment

  • 9.1 Waste Disposal

  • 9.2 Noise

  • 9.3 Giant Hogweed/ Japanese Knotweed

  • 9.4 Spill Kits

  • 9.5 Protected Species

  • 9.6 Protected Areas

  • 9.7 Dust/Fumes

  • 9.8 Water Pollution

  • 9.9 Oil & Diesel Storage

10 Behavioural Safety

10 Behavioural Safety

  • 10.1 Hazard Awareness

  • 10.2 Compliance With Risk Assessments

  • 10.3 Correct Manual Handling

  • 10.4 ID/Access Permits

  • 10.5 Contact Lens Wearers Have Glasses

  • 10.6 Life Saving Rules

11 Welfare

11 Welfare

  • 11.1 Toilets And Washing Facilities

  • 11.2 Drinking Water

  • 11.3 Changing/Drying Rooms

  • 11.4 Transient Sites

  • 11.5 Security

12 Quality

12 Quality

  • 12.1 Has work been carried out to clients specifications?

  • 12.2 Ongoing Site Checks Satisfactory?

  • 12.3 Are all products used to specification?

  • 12.4 Testing undertaken and recorded?

  • 12.5 Site Diary Been Kept?

  • 12.6 Have all non-conformances been addressed satisfactorily?

13 Name Of Subcontractor

Name Of Subcontractor

  • Name

  • Has the SC received a copy?

Description Of Works

Description Of Works

  • What work is being carried out?

Observations/ Actions

Observations/Actions

  • Item Ref No.

  • Observations/Actions Required

  • Actions Taken

  • Item Ref No.

  • Observations/Actions Required

  • Actions Taken

  • Item Ref No.

  • Observations/Actions Required

  • Actions Taken

  • Item Ref No.

  • Observations/Actions Required

  • Actions Taken

  • Item Ref No.

  • Observations/Actions Required

  • Actions Taken

  • General Observations

Completion (Report Handed in to Systems Manager with FIVE working days)

  • Received By:

  • Signed

  • Completed By:

  • Signed

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.