Title Page

  • To be completed by Project Supervisor or Nominated person weekly from the start of construction work on site. Completed forms are to be kept readily available (preferably on site) for the duration of construction works, after which time shall form part of the CDM Health and Safety file.

  • Sensible Monitoring Audit Completed By:

  • Site Manager:

  • Contract Number:

  • Project Title:

  • Conducted on

Staff and Vehicle Appearance

  • Any H&S actions identified shall be entered onto Audit / Inspection Action Log and brought to the urgent attention of the appropriate personnel as soon as possible. Contractor / Project Manager to be notified of actions required / taken.

  • 1) Correct personal protective equipment in use

  • Comments:

  • Attach any images relevant to question 1 here.

  • 2) Staff carrying ID card appropriate to task being undertaken

  • Comments:

  • Attach any images relevant to question 2 here.

  • 3) Staff with current issue of safety at street and road works code of practice

  • Comments:

  • Attach any images relevant to question 3 here.

  • 4) Vehicle in a presentable condition - using hazard safety lights or lights

  • Comments:

  • Attach any images relevant to question 4 here.

  • 5) Information board displayed

  • Comments:

  • Attach any images relevant to question 5 here.

Signing, Lighting and Guarding

  • 6) Approach and working site signs comply with code of practice

  • Comments:

  • Attach any images relevant to question 6 here.

  • 7) Sand bags in use if weighting required

  • Comments:

  • Attach any images relevant to question 7 here.

  • 8) Minimum widths of carriageway and pedestrian walkway maintained

  • Comments:

  • Attach any images relevant to question 8 here.

  • 9) General condition of signs at site good

  • Comments:

  • Attach any images relevant to question 9 here.

  • 10) Safety zone correct and appropriately sized cones in use

  • Comments:

  • Attach any images relevant to question 10 here.

  • 11) Cone spacing correct

  • Comments:

  • Attach any images relevant to question 11 here.

  • 12) Lead in and exit tapers correct for site conditions

  • Comments:

  • Attach any images relevant to question 12 here.

  • 13) Reflectively of signs, cones and barrier meets requirements

  • Comments:

  • Attach any images relevant to question 13 here.

  • 14) Correct use of pedestrian barrier (hand and tapping rail in use)

  • Comments:

  • Attach any images relevant to question 14 here.

Traffic Signals

  • 15) Correct portable traffic control system installed with correct time settings

  • Comments:

  • Attach any images relevant to question 15 here.

  • 16) Signal heads and detectors located and sighted at the correct position

  • Comments:

  • Attach any images relevant to question 16 here.

  • 17) Batteries are fully charged to cover duration of work

  • Comments:

  • Attach any images relevant to question 17 here.

Documentation

  • 18) Risk assessment completed

  • Comments:

  • Attach any images relevant to question 18 here.

  • 19) Copy of method statement on site

  • Comments:

  • Attach any images relevant to question 19 here.

  • 20) Copy of TM drawing on site (If required)

  • Comments:

  • Attach any images relevant to question 20 here.

  • 21) Has contractor street works supervisor signed off arrangements where required

  • Comments:

  • Attach any images relevant to question 21 here.

Sign Off Audit

  • Print Name:

  • Signature:

  • Project Manager Name:

  • Signature:

  • Designation:

  • Select date

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