SQW

People On Site And Site Location

• Location
  Address

• Audited by

• Audit conducted on

  Date

• Contractor on site

• Job Number

• Template Name

  TCS (PWP) Site Safety Audit

• Business Area

  Select Capital and Commercial Service (CCS) Chief Engineer

  • Capital and Commercial Service (CCS)
  • Chief Engineer

• Select your department

  Select

• Select your department

  Select

• Workstream working on

• Vehicle Reg

• Team Leader

• Operative 2

• Operative 3

• Operative 4

• Is Site Active

  Yes

  No

  N/A

• Audit Date

  Date

• Work description

• Unsafe condition, act or omission very likely to cause a significant accident giving reason to stop work Immediately or is the site set up in a safe manner, ensuring the crew's safety and members of the public have been taken into consideration. Please take photos to show set up.

  Compliant

  Non-Compliant

  N/A

• All Ops' carrying ID Cards and Leptospirosis (RAT) card

  Yes

  No

  N/A

• PTD forms available and if applicable have they been signed

  Yes

  No

  N/A

• Do crew have calling cards

  Yes

  No

  N/A

Health & Safety, Equipment & TM

• Risk assessment completed & understood, visitors inducted/briefed and signed on to SSRA

  Yes

  No

  N/A

• At the time of the audit was a safe system of work being practised

  Yes

  No

  N/A

• All Ops' have their training cert's on site and in date(Take Photo Evidence)

  Yes

  No

  N/A

• All Ops' have the correct and relevant PPE as required to carry out the task and is in use

  Yes

  No

  Rectified onsite

• All crew members First Aid trained and have adequately stocked first aid box and eye wash

  Yes

  No

  N/A

• Eye protection available and in use (jetting visors, safety glasses, goggles)

  Yes

  No

  N/A

• The team is aware of the process for reporting accidents, customer complaints, close calls

  Yes

  No

  N/A

• Crew aware of Manual Handling techniques and prevention

  Yes

  No

  N/A

• Both Company and Client van packs in date and includes generic risk assessements and COSHH assessemnets

  Yes

  No

  N/A

• TM specific controls relevant to working in the Highway in place and being observed. (Chap 8, Traffic Lights, Road Closure)

  Yes

  No

  N/A

• Work areas are suitably signed, lighted and guarded

  Yes

  No

  N/A

• Task specific signage displayed

  Yes

  No

  N/A

• Are any temporary openings i.e, manholes/shafts etc adequately protected

  Yes

  No

  N/A

• Has suitable access and egress from the site been provided

  Yes

  No

  N/A

• Where applicable are overhead services controlled

  Yes

  No

  N/A

• All work equipment and tools in good condition and fit for purpose

  Yes

  No

  N/A

• Where required gas detectors calibrated and charged, gas test carried out and results recorded. Charging unit available on site

  Yes

  No

  N/A

High Pressure Water Jetting & CCTV Surveying

• Leader hose fitted and all hoses free from damage

  Yes

  No

  N/A

• Correct jetting heads in use

  Yes

  No

  N/A

• Correct skids for camera availble, in use

  Yes

  No

  N/A

• Do crew have a Cat & Genny and are trained and capable of using it ?

  Yes

  No

  N/A

• Pollution prevention controls in place (drains and watercourses protected, spill kit available, secondary containment available where required)

  Yes

  No

  N/A

• Plant service records available for inspection

  Yes

  No

  N/A

• Evidence all relevant electrical equipment has been inspected/tested

  Yes

  No

  N/A

Confined Space

• Op's hold correct training cert's for the confined space entry & Top Man, and they are capable of using Safety Equipment?

  Yes

  No

  N/A

• Sufficient lighting in place within the confined space

  Yes

  No

  N/A

• Full Safety kit available/escape set, Calibrated & in date ?

  Yes

  No

  N/A

• Work at height/falls from height

  Yes

  No

  N/A

• Ladders & Step Ladders if in use at all are fit for purpose, secured safely and tagged

  Yes

  No

  N/A

Patching & Relining inc. Re-rounding

• Do all crew members understand the correct mixing guidelines for any chemicals they are carrying ?

  Yes

  No

  N/A

• Are all Air Hoses free from damage, any noticable kinks

  Yes

  No

  N/A

• Rerounding operation set up correctly and crew have the necessary waste bags for Asbestos

  Yes

  No

  N/A

• Chemicals/flammable liquids securely stored away from sources of ignition and labelled, drip bund in use

  Yes

  No

  N/A

• Protection against scolding in place Hot Cure works

  Yes

  No

  N/A

• Suitable ventillation in place for the task

  Yes

  No

  N/A

• Scaffold & other temporary work platforms tagged with set up date

  Yes

  No

  N/A

Vehicle

• Vehicle daily check sheet completed

  Yes

  No

  N/A

• Vehicle externally and internally clean, cab free from clutter, bodywork acceptable standard, livery applied

  Yes

  No

  N/A

• Sufficient TM to perform current days tasks

  Yes

  No

  N/A

• Storage secured, area free from hazards

  Yes

  No

  N/A

• Drivers licence in accordance with vehicle and trailer legal requirement

  Yes

  No

  N/A

• Keys removed from vehicle, stored securely

  Yes

  No

  N/A

• Vehicle visibly within the legal weight limit

  Yes

  No

  N/A

• Lights working including flashing roof beacon, lenses clean and undamaged

  Yes

  No

  N/A

• Tyres visibly within legal limits

  Yes

  No

  N/A

• Windowscreen free from damage/cracks, driver has clear vision.

  Yes

  No

  N/A

• Is vehicle height displayed

  Yes

  No

  N/A

Excavation Works in highway and/or private property

• Have the works been adequately planned including liaison with the highway authority permit /notice in place, PTD signed

  Yes

  No

  N/A

• PPE being used as per the Operatives RAMS, Site rules and COSHH assessments

  Yes

  No

  N/A

• Do crew have a Cat & Genny and are trained and capable of using it ?

  Yes

  No

  N/A

• Utility plans on site and up to date and all service's clearly identified

  Yes

  No

  N/A

• Work areas are suitably signed, lighted and guarded

  Yes

  No

  N/A

• Appropriate number of NRSWA qualified operatives on site (certificates in place)

  Yes

  No

  N/A

• is Heras fencing in place where needed and double clipped

  Yes

  No

  N/A

• All machinery, plant and spoil within the barriers

  Yes

  No

  N/A

• All plates / footway boards secured appropriately for the location and correctly maintained

  Yes

  No

  N/A

• Where applicable are HAVS calculations available

  Yes

  No

  N/A

• Working at height controls in place as per RAMS and SSRA

  Yes

  No

  N/A

• Is shoring in place where needed and to satisfactory standard

  Yes

  No

  N/A

• A Business Open as Usual Sign is in place at either end of the works where there are businesses present

  Yes

  No

  N/A

• Spoil correctly separated and stored safe distance from excavation.

  Yes

  No

  N/A

Environmental, Hygiene & Welfare

• Adequate supply of fresh water

  Yes

  No

  N/A

• Adequate washing facilities available i.e soap, wipes, hand towel etc

  Yes

  No

  N/A

• If any specific environmental controls are in place, are these considered as adequate

  Yes

  No

  N/A

• Has provision been made for the disposal of site waste

  Yes

  No

  N/A

• Chemicals/flammable liquids securely stored away from sources of ignition and labelled, drip bund in use

  Yes

  No

  N/A

• The storage of Hazardous substances (COSHH) is adequately controlled

  Yes

  No

  N/A

• Client specific standpipe available and correct storage for standpipe being used

  Yes

  No

  N/A

• Hydrant key and hydrant location list available, correct hydrant being used

  Yes

  No

  N/A

• Chlorine tablets available and chlorine solution labelled and dated

  Yes

  No

  N/A

• Spill Kit available

  Yes

  No

  N/A

Customer and third party management

• Are permit/customer information boards displayed, with correct details

  Yes

  No

  N/A

• Access to shops and houses being maintained. Pedestrian and vehicular access satisfactory

  Yes

  No

  N/A

• Members of the public and any 3rd parties adequately protected

  Yes

  No

  N/A

• Are overshoes available if needed

  Yes

  No

  N/A

• Do you want to capture Good Practices?

  Yes

  No

  N/A

• Do you want to assign review status?

  Yes

  No

  N/A

• Please select a status type

  Effective

  Satisfactory

  Improvements required

  Ineffective

Contractor Sign Off

• Contractor Rep Comments

• Contractor Signature

  Sign

Auditors Sign off

• Auditor's Comments

• Auditor's Signature

  Sign