• Name of SPC

Sentinel Number

SPC Certification

  • TSW035, Medical & D&A

  • Signature

  • Date

  • Name of Mentor

  • TSW035

  • Mentor Signature

  • Line

  • Road/s booked with PWT?

  • Location

  • No of Staff and all relevant certification checks completed.

  • Nature of Work

  • Reason for Inspection (i.e. Familiarity; Competence; Post Incident, New SPC)

  • Site access booking / Signing in procedures / Compliance for Rule Book 10 (if applicable)

  • Planning of the work / Planning protection / Safe Access to Track – Rule Book 14 / 16 (if applicable)

  • Relevant documentation/Method statements/Risk assessments/SSI/F3333 & SPC Pack

  • Consideration of Public / Contractors / Other Work Parties (pre-worksite)

  • Movement of Tools / Materials – Manual Handling / Pre Site set up

  • Workgroup safety briefing

  • Movement to Site / Worksite Set Up including Rule Book 18 (where applicable)

  • Compliance Paperwork Entries / Paperwork Organisation.

  • Monitoring Worksite arrangements including high risk activity controls (WAH / C.A.T Scan / MEWP)

  • Identification of Hazards / Recording and Controlling (Point of Work Risk Assessment)

  • Completion of Works / Site clear checks

  • Signing out procedures / Paperwork entries post shift – Rule Book 10/14/16 where applicable

  • Understanding of incidents / accidents / escalation (questions by competent person)

  • Other relevant information / Observations / Comments

  • Recommendations

  • Reviewed By:

  • Signature:

  • Date:

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