Supplementary CHecks During Joint H&S Inspections

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Location

• Select date and time

  Date

• Road Name

• Mark location
  Address

• Length of road

• Select road speed

  20 mph

  30 mph

  40 mph

  50 mph

• Are there Any hazards already identified

  yes

  no

• Select hazards

  Select road liable to flooding adverse weather Grvel concealed entrance road on incline blind bends restricted access inadequate lighting Speed cameraa mud on road Magor junction pot holes schools /community centre adverse camber road street works Restricted space overhanging trees heavily shaded areas other

  • road liable to flooding
  • adverse weather
  • Grvel
  • concealed entrance
  • road on incline
  • blind bends
  • restricted access
  • inadequate lighting
  • Speed cameraa
  • mud on road
  • Magor junction
  • pot holes
  • schools /community centre
  • adverse camber
  • road street works
  • Restricted space
  • overhanging trees
  • heavily shaded areas
  • other

• Identify hazards at inspection

  Select road liable to flooding adverse weather Grvel concealed entrance road on incline blind bends restricted access inadequate lighting Speed cameraa mud on road Magor junction pot holes schools /community centre adverse camber road street works Restricted space overhanging trees heavily shaded areas other

  • road liable to flooding
  • adverse weather
  • Grvel
  • concealed entrance
  • road on incline
  • blind bends
  • restricted access
  • inadequate lighting
  • Speed cameraa
  • mud on road
  • Magor junction
  • pot holes
  • schools /community centre
  • adverse camber
  • road street works
  • Restricted space
  • overhanging trees
  • heavily shaded areas
  • other

Checks completed in back office

• Newly identified hazards

• Significance of hazard

  low

  medium

  high

• Actions required

  none

  update RRA for section of road

  check other roads on round

• Person responsible for action

  Paul Hickman

  Ian field

  Chris lane

  other named person

• Name other person

• Agreed date to be competed

  Date

Staff training checks

• Name of operative

• Position held

  loader

  street sweeper

  charge hand

  driver

• Type of employment

  full time

  agency

• Date of last training session

  Date

• Training completed as required

  yes

  no

• Action required

  none

  further session needed

  report to management

• Session required To be completed by

Completion and checks

• Hazards checked

• New hazards recorded

• Dates for actions agreed

• Not other defects found at time of inspection

• Completed by MSDC Officer

  Sign

• Date completed

  Date

• completed by Serco Supervisor

  Sign

• Date completed

  Date