Streetworks Audit - Public - duplicate

• Document No. OHSF-PR-06-11 Version 1 Revision 0 Dated 14/07/2017

• (Format:- City - Job Pack / Work order No) E.g Aberdeen SO 12345 Always insert City name and Job Pack number if known

• Location - Enter Location of Audit / Inspection (Please use the - Locate me tab)
  Address

• Location

  Location A

  Location B

  Location C

• Who is the Contractor operating on behalf of the Principal Contractor?

  Contractor A

  Contractor B

  Contractor C

• Auditor / Inspector?

  Employee 1

  Employee 2

  Employee 3

  Employee 4

Select What Type of Audit / Inspection is to be completed.

• What type of Audit are you doing today?

  Select

• Photographic Evidence (Select ADD to start)

Take site photograph (Select Add to add additional site visit

• Take images of this visit

  Media

• Enter date and Time of Image

  Date

• Quick Site Visit: Any Site Issues?

  If Yes, complete the observations box below

• Add Additional Images if required

  Media

All personnel conducting site audits and inspections must ensure that all findings are recognised by the Contactor lead person on site (They do not have to agree the findings but must acknowledge your audit)

• Contractor Signature of recognition of findings

  Sign

• Ensure all actions have been assigned and the senior contractor has provided signature recognising findings

  Yes

  No

  N/A

Audit Complete? (Check all mandatory fields have been completed)

• Auditor

  Employee 1

  Employee 2

  Employee 3

  Employee 4

• Name and Signature

  Sign

Signing Lighting & Guarding

• Are Courtesy Boards displayed and contain correct information?

  Yes

  No

  N/A

• Do Adequate advance warning signs exist?

  Yes

  No

  N/A

• Are Advanced warnings signs in correct sequence, distance and suitably fixed to prevent being blown down or out of position?

  Yes

  No

  N/A

• Is lighting available for the work area?

  Yes

  No

  N/A

Barriers and Work Area

• Are Traffic / Pedestrian Segregation Barriers fitted?

  Yes

  No

  N/A

• Are Barriers supported by suitable bases and linked together

  Yes

  No

  N/A

• Are all the working equipment contained within the barriered work area (Including spoil)?

  Yes

  No

  N/A

• Is work area of a suitable size to operate safely?

  Yes

  No

  N/A

• Site tidiness (Housekeeping) - is site free of trip hazards (best as Possible)?

  Yes

  No

  N/A

• (Barriers) - Site Comments

• Add media

  Media

Footways

• Is a pedestrian walkway required?

  Yes

  No

• Is the pedestrian walkway the correct width (At least 1.2m)

  Yes

  No

  N/A

• Are footway ramps fitted and fixed?

  Fitted and Acceptable

  Not Fitted but required

  Not Applicable

• Are pedestrian arrows in place and correctly fitted

  Fitted and Acceptable

  Not Fitted but required

  Not Applicable

• Are Footway Closed signs in use

  Yes

  No

  N/A

• Is there a safe method for pedestrians to avoid the road / Carriageway whilst passing works?

  Yes

  No

  N/A

• (Footways / Paths) - Site Comments

• Add Images if required

  Media

Welfare

• Is Drinking water and vessels made available to the operatives?

  Yes

  No

  N/A

• Are washing facilities available?

  Yes

  No

  N/A

• Are toilet facilities within a ten minutes walking distance?

  Yes

  No

  N/A

• Is First Aid Box stocked?

  Yes

  No

  N/A

• What is the expiry date of First Aid Stocks in First Aid Box

• Fire Extinguishers held (vehicle & Site)

  Yes

  No

  N/A

• What is the expiry date of Fire Extinguishers?

• Site Observations (Welfare)

• Add Images if Required

  Media

PPE

• Is PPE in good order? (Clean and maintained)

  Yes

  No

  N/A

• Is PPE being worn correctly and correct for the works being conducted.

  Yes

  No

  N/A

• Is there suitable storage for PPE in the vehicles provided?

  Yes

  No

  N/A

Plant & Equipment

• Is Plant and Euipment required on site at time of audit?

  Yes

  No

  N/A

• Are Plant / Equipment etc in good operational order?

  Yes

  No

  N/A

• Plant & Equipment held in Calibration / Service Date?

Click Add for more

• Equipment Name / Type

• Calibration / Service due date

• Site Comments (Plant & equipment)

• Add Images if required

  Media

• Is there a spill kit available for any environmental issues, fuel leaks etc

  Yes

  No

  N/A

Documentation

• Has Site Risk Assessment been conducted for the current operations?

  Yes

  No

  N/A

• Have all operatives signed the Risk Assessment or evidence of briefing?

  Yes

  No

  N/A

• Are method Statements in use and applicable

  Yes

  No

  N/A

• Are COSHH Assessment and Safety Data Sheets Available for all hazardous substances held on site?

  Yes

  No

  N/A

• Are utility drawings onsite and available

  Yes

  No

  N/A

• Site Comments (Documentation)

• Add Images if Required

  Media

Traffic Management

• Is Traffic Management in place and Required?

  Yes

  No

  N/A

• Is Traffic Management suitable for location

  Yes

  No

  N/A

• Is Traffic Management set up in accordance with Plan and assessment?

  Yes

  No

  N/A

• Site Comments (Traffic Management)

• Add Images if Required

  Media

Noticing and Competence

• Are NRSWA Noticing / TTRO's in place and displayed?

  Yes

  No

  N/A

• Is the noticing valid for the current operations?

  Yes

  No

  N/A

• Have Streetworks personnel got the relevant NRSW Cards and plant certificates available for inspection?

  Yes

  No

  N/A

• List Names of operatives sampled

Click ADD for another

• Names of Operative

• Qualification Expiry Date

• Site Comments (Noticing)

• Add Images if Required

  Media

Quality Workmanship

• Backfilled Apparatus and duct

  Acceptable

  Not Acceptable

  Not Applicable

• Backfill materials

  Acceptable

  Not Acceptable

  Not Applicable

• Is backfill compaction adequate?

  Acceptable

  Not Acceptable

  Not Applicable

• Have compaction tests been conducted?

  Acceptable

  Not Acceptable

  Not Applicable

• Any defects Identified

  Yes

  No

  N/A

Chambers

• Cover and frame seated correctly

  Acceptable

  Not Acceptable

  Not Applicable

All personnel conducting site audits and inspections must ensure that all findings are recognised by the Contactor lead person on site (They do not have to agree the findings but must acknowledge your audit)

• Contractor Signature of recognition of findings

  Sign

• Ensure all actions have been assigned and the senior contractor has provided signature recognising findings

  Yes

  No

  N/A

Audit Complete? (Check all mandatory fields have been completed)

• Auditor

  Employee 1

  Employee 2

  Employee 3

  Employee 4

• Name and Signature

  Sign

Signing Lighting & Guarding

• Are Courtesy Boards displayed and contain correct information?

  Yes

  No

  N/A

• Do Adequate advance warning signs exist?

  Yes

  No

  N/A

• Are Advanced warnings signs in correct sequence, distance and suitably fixed to prevent being blown down or out of position?

  Yes

  No

  N/A

• Is lighting available for the work area?

  Yes

  No

  N/A

Barriers and Work Area

• Are Traffic / Pedestrian Segregation Barriers fitted?

  Yes

  No

  N/A

• Are Barriers supported by suitable bases and linked together

  Yes

  No

  N/A

• Are all the working equipment contained within the barriered work area (Including spoil)?

  Yes

  No

  N/A

• Is work area of a suitable size to operate safely?

  Yes

  No

  N/A

• Site tidiness (Housekeeping) - is site free of trip hazards (best as Possible)?

  Yes

  No

  N/A

• (Barriers) - Site Comments

• Add Images if Required

  Media

Footways

• Is a pedestrian walkway required?

  Yes

  No

• Is the pedestrian walkway the correct width (At least 1.2m)

  Yes

  No

  N/A

• Are footway ramps fitted and fixed?

  Fitted and Acceptable

  Not Fitted but required

  Not Applicable

• Are pedestrian arrows in place and correctly fitted

  Fitted and Acceptable

  Not Fitted but required

  Not Applicable

• Are Footway Closed signs in use

  Yes

  No

  N/A

• Is there a safe method for pedestrians to avoid the road / Carriageway whilst passing works?

  Yes

  No

  N/A

• (Footways / Paths) - Site Comments

• Add Images if Required

  Media

Welfare

• Is Drinking water and vessels made available to the operatives?

  Yes

  No

  N/A

• Are washing facilities available?

  Yes

  No

  N/A

• Are toilet facilities within a ten minutes walking distance?

  Yes

  No

  N/A

• Is First Aid Box stocked?

  Yes

  No

  N/A

• What is the expiry date of First Aid Stocks in First Aid Box

• Fire Extinguishers held (vehicle & Site)

  Yes

  No

  N/A

• Next Fire Extinguisher Test date

• Site Comments (Welfare)

• Add Images if Required

  Media

PPE

• Is PPE in good order? (Clean and maintained)

  Yes

  No

  N/A

• Is PPE being worn correctly and correct for the works being conducted.

  Yes

  No

  N/A

• Is there suitable storage for PPE in the vehicles provided?

  Yes

  No

  N/A

Plant & Equipment

• Is Plant and Euipment required on site at time of audit?

  Yes

  No

  N/A

• Are Plant / Equipment etc in good operational order?

  Yes

  No

  N/A

• Plant & Equipment held in Calibration / Service Date?

Click Add for more

• Equipment Name / Type

• Calibration / Service due date

  Date

• Comments

• Add Images if Required

  Media

• Is there a spill kit available for any environmental issues, fuel leaks etc

  Yes

  No

  N/A

Documentation

• Has Site Risk Assessment been conducted for the current operations?

  Yes

  No

  N/A

• Have all operatives signed the Risk Assessment or evidence of briefing?

  Yes

  No

  N/A

• Are method Statements in use and applicable

  Yes

  No

  N/A

• Are COSHH Assessment and Safety Data Sheets Available for all hazardous substances held on site?

  Yes

  No

  N/A

• Are utility drawings onsite and available

  Yes

  No

  N/A

• Site Comments (Documentation)

• Add Images if Required

  Media

Traffic Management

• Is Traffic Management in place and Required?

  Yes

  No

  N/A

• Is Traffic Management suitable for location

  Yes

  No

  N/A

• Is Traffic Management set up in accordance with Plan and assessment?

  Yes

  No

  N/A

• Site Comments (Traffic Management)

• Add Images if Required

  Media

Quality Workmanship

• Reinstatement Edge Depression

  Acceptable

  Not Acceptable

  Not Applicable

• Reinstatement trips

  Acceptable

  Not Acceptable

  Not Applicable

• Reinstatement Surface Depression

  Acceptable

  Not Acceptable

  Not Applicable

• Reinstatement Crowning

  Acceptable

  Not Acceptable

  Not Applicable

• Reinstatement Texture Depth

  Acceptable

  Not Acceptable

  Not Applicable

• Reinstatement other slabs / Tactiles / Pavers

  Acceptable

  Not Acceptable

  Not Applicable

• Reinstatement Structure

  Acceptable

  Not Acceptable

  Not Applicable

• Lines and markings replaced (Dependant upon phase of works)

  Acceptable

  Not Acceptable

  Not Applicable

• Site Comments (Quality)

• Add Images if Required

  Media

Chambers

• Cover and frame seated correctly

  Acceptable

  Not Acceptable

  Not Applicable

All personnel conducting site audits and inspections must ensure that all findings are recognised by the Contactor lead person on site (They do not have to agree the findings but must acknowledge your audit)

• Contractor Signature of recognition of findings

  Sign

• Ensure all actions have been assigned and the senior contractor has provided signature recognising findings

  Yes

  No

  N/A

Audit Complete? (Check all mandatory fields have been completed)

• Auditor

  Employee 1

  Employee 2

  Employee 3

  Employee 4

• Name and Signature

  Sign

Signing Lighting & Guarding

• Are Courtesy Boards displayed and contain correct information?

  Yes

  No

  N/A

• Do Adequate advance warning signs exist?

  Yes

  No

  N/A

• Are Advanced warnings signs in correct sequence, distance and suitably fixed to prevent being blown down or out of position?

  Yes

  No

  N/A

• Is lighting available for the work area?

  Yes

  No

  N/A

Barriers and Work Area

• Are all work areas (Cable blowing and Receiving) set up correctly

  Yes

  No

  N/A

• Are Traffic / Pedestrian Segregation Barriers fitted?

  Yes

  No

  N/A

• Are Barriers supported by suitable bases and linked together

  Yes

  No

  N/A

• Are all the working equipment contained within the barriered work area (Including spoil)?

  Yes

  No

  N/A

• Is work area of a suitable size to operate safely?

  Yes

  No

  N/A

• Site tidiness (Housekeeping) - is site free of trip hazards (best as Possible)?

  Yes

  No

  N/A

• (Barriers) - Site Comments

• Add Images if Required

  Media

Footways

• Is a pedestrian walkway required?

  Yes

  No

• Is the pedestrian walkway the correct width (At least 1.2m)

  Yes

  No

  N/A

• Are footway ramps fitted and fixed?

  Fitted and Acceptable

  Not Fitted but required

  Not Applicable

• Are pedestrian arrows in place and correctly fitted

  Fitted and Acceptable

  Not Fitted but required

  Not Applicable

• Are Footway Closed signs in use

  Yes

  No

  N/A

• Is there a safe method for pedestrians to avoid the road / Carriageway whilst passing works?

  Yes

  No

  N/A

• (Footways / Paths) - Site Comments

• Add Images if Required

  Media

Welfare

• Is Drinking water and vessels made available to the operatives?

  Yes

  No

  N/A

• Are washing facilities available?

  Yes

  No

  N/A

• Are toilet facilities within a ten minutes walking distance?

  Yes

  No

  N/A

• Is First Aid Box stocked?

  Yes

  No

  N/A

• What is the expiry date of First Aid Stocks in First Aid Box

• Fire Extinguishers held (vehicle & Site)

  Yes

  No

  N/A

• Next Fire Extinguisher Test date

• Site Comments (Welfare)

• Add Images if Required

  Media

PPE

• Is PPE in good order? (Clean and maintained)

  Yes

  No

  N/A

• Is PPE being worn correctly and correct for the works being conducted.

  Yes

  No

  N/A

• Is there suitable storage for PPE in the vehicles provided?

  Yes

  No

  N/A

• Site Comments (PPE)

• Add Images if Required

  Media

Plant & Equipment

• Is Plant and Euipment required on site at time of audit?

  Yes

  No

  N/A

• Are Plant / Equipment etc in good operational order?

  Yes

  No

  N/A

• Plant & Equipment held in Calibration / Service Date?

Click Add for more

• Equipment Name / Type

• Calibration date / Inspection Date / Service Date

• Site Comments (Plant & Equipment)

• Add Images if Required

  Media

• Is there a spill kit available for any environmental issues, fuel leaks etc

  Yes

  No

  N/A

Documentation

• Has Site Risk Assessment been conducted for the current operations?

  Yes

  No

  N/A

• Have all operatives signed the Risk Assessment or evidence of briefing?

  Yes

  No

  N/A

• Are method Statements in use and applicable

  Yes

  No

  N/A

• Are COSHH Assessment and Safety Data Sheets Available for all hazardous substances held on site?

  Yes

  No

  N/A

• Are utility drawings onsite and available

  Yes

  No

  N/A

• Site Comments (Documentation)

• Add Images if Required

  Media

Traffic Management

• Is Traffic Management in place and Required?

  Yes

  No

  N/A

• Is Traffic Management suitable for location

  Yes

  No

  N/A

• Is Traffic Management set up in accordance with Plan and assessment?

  Yes

  No

  N/A

• Site Comments (Traffic management)

• Add Images if Required

  Media

Noticing and Competence

• Are NRSWA Noticing / TTRO's in place and displayed?

  Yes

  No

  N/A

• Is the noticing valid for the current operations?

  Yes

  No

  N/A

• Have Streetworks personnel got the relevant NRSW Cards and plant certificates available for inspection?

  Yes

  No

  N/A

• List Names of operatives sampled

Click ADD for another

• Names of Operative

• Qualification Expiry Dtae

  Date

Chambers

• Cover and frame seated correctly

  Acceptable

  Not Acceptable

  Not Applicable

• Joint Enclosure Bracket fitted?

  Yes

  No

  N/A

• Joint Enclosure Mounted Correctly

  Yes

  No

  N/A

• Feed Fibre Labelled?

  Acceptable

  Not Acceptable

  Not Applicable

• Fibre Bundle Labelled?

  Acceptable

  Not Acceptable

  Not Applicable

• Hangers fitted where required?

  Acceptable

  Not Acceptable

  Not Applicable

• Spare Tubes Blanked?

  Acceptable

  Not Acceptable

  Not Applicable

• Connectors Protected?

  Acceptable

  Not Acceptable

  Not Applicable

• Box Cleaned out?

  Acceptable

  Not Acceptable

  Not Applicable

• Any defects Identified

  Yes

  No

  N/A

All personnel conducting site audits and inspections must ensure that all findings are recognised by the Contactor lead person on site (They do not have to agree the findings but must acknowledge your audit)

• Contractor Signature of recognition of findings

  Sign

• Ensure all actions have been assigned and the senior contractor has provided signature recognising findings

  Yes

  No

  N/A

Audit Complete? (Check all mandatory fields have been completed)

• Auditor

  Employee 1

  Employee 2

  Employee 3

  Employee 4

• Name and Signature

  Sign

Chamber and Splice Enclosure Quality Check list

• Splice Point Enclosure ID

• Splice Point Enclosure Address

• GPS Location
  Address

• Chamber View Closed

  Media

• Chamber View Open

  Media

• Entry Points Externally

  Media

• Entry Points Internally

  Media

• Storage basket

  Media

• Splice Trays (Font View)

  Media

• Cover and frame seated correctly

  Acceptable

  Not Acceptable

  Not Applicable

• Comments

All personnel conducting site audits and inspections must ensure that all findings are recognised by the Contactor lead person on site (They do not have to agree the findings but must acknowledge your audit)

• Contractor Signature of recognition of findings

  Sign

• Ensure all actions have been assigned and the senior contractor has provided signature recognising findings

  Yes

  No

  N/A

Audit Complete? (Check all mandatory fields have been completed)

• Auditor

  Employee 1

  Employee 2

  Employee 3

  Employee 4

• Name and Signature

  Sign