TELECOMS INSPECTION - HSE - HEALTH, SAFETY & ENVIRONMENT -

• Conducted on

  Date

• Reporter's Name & Company Represented:

• Location
  Address

INSPECTION DETAILS

• Job Title of reporter:

• Company Inspected:

• Works Team Name / Reference

• Contractor Works Manager / Supervisor:

• Team Leader's Name:

• no. of Operatives on Site:

• Works Vehicle's Registration no.

• LCRA Borough PERMIT no.

• Job Pack / Section Reference:

NRSWA RESTRICTIONS

• Are the works able to carry on under current conditions?

  Yes

  No

  N/A

1.0 Site Safety

• Is all required PPE available and being worn for individual tasks?

  Yes

  No

  N/A

• Is a First Aid Kit available, in a satisfactory and replenished condition?

  Yes

  No

  N/A

• Do the team have access to adequate welfare facilities?

  Yes

  No

  N/A

• Is there a copy of the NGE EMERGENCY Management Plan?

  Yes

  No

  N/A

• Are gas cylinders secured & stored correctly - IF APPLICABLE?

  Yes

  No

  N/A

• Are all hand tools in good condition and meet the requirements of standard issue?

  Yes

  No

  N/A

• Are all power tools in good condition and being used safely?

  Yes

  No

  N/A

• Are vibrating tools maintained in good working order?

  Yes

  No

  N/A

• Is all Vibrating Equipment assessed and tagged?

  Yes

  No

  N/A

• Are appropriate Cable Locators available, calibrated and in use?

  Yes

  No

  N/A

• Is Gas Detection Equipment on site appropriate, in working order and correctly used, - IF APPLIABLE?

  Yes

  No

  N/A

• Are the correct type of chamber and joint box/cabinet keys available?

  Yes

  No

  N/A

2.0 Vehicles

• Do vehicles have working beacons and approriate chevron markings?

  Yes

  No

  N/A

• Are vehicles tidy and clean?

  Yes

  No

  N/A

• Are vehicles parked safely & securely without causing obstruction?

  Yes

  No

  N/A

3.0 Work Pack & Site Documentation

• Are suitable utility Drawings in pack & Are safe dig drawings on site within 30 day expiry period?

  Yes

  No

  N/A

• Is there legible copies of the work specific JOB PACK & generic GANG PACK on site and understood?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Are Site Specific Risk assessments in place?

  Yes

  No

  N/A

• Are the RAMS provided relevant to the specific works & have all personnel signed to acknowledge understanding?

  Yes

  No

  N/A

• Have works been undertaken as planned?

  Yes

  No

  N/A

4.0 Works Practices / H&S

• Are safe digging practices and HSG47 being adhered to?

  Yes

  No

  N/A

• Are all appropriate buried services identified and traced?

  Yes

  No

  N/A

• Are all identified buried services visibly marked?

  Yes

  No

  N/A

• Are excavations stable and free from excess water?

  Yes

  No

  N/A

• Are stacked and excavated materials away from edge of the excavation?

  Yes

  No

  N/A

• Is work site tidy and free from tripping hazards?

  Yes

  No

  N/A

• Has any damage caused by 3rd parties been photographed and the client informed?

  Yes

  No

  N/A

5.0 NRSWA

• Has the appropriate opening notice/permit to work been raised and is available to view on site?

  Yes

  No

  N/A

• Are there persons on site with the correct NRSWA certification?

  Yes

  No

  N/A

• Is the Signing & Guarding Layout in accordance with the ACOP?

  Yes

  No

  N/A

• Is the site clearly signed and directions understandable by motorists or pedestrians

  Yes

  No

  N/A

• Are all works taking place within a safely barriered area?

  Yes

  No

  N/A

• Are the correct Works information boards provided and in use?

  Yes

  No

  N/A

• Do information boards display appropriate notification and contact numbers?

  Yes

  No

  N/A

• Are signs, cones, barriers etc, clean and in good condition?

  Yes

  No

  N/A

• Are kerb ramps and pedestrian ramps in use where necessary?

  Yes

  No

  N/A

6.0 ON SITE PLANT / VEHICLE WORTHINESS

• Are all operators trained and competent for the items they are using e.g. excavator driver, dumper driver etc

  Yes

  No

  N/A

• Are maintenance records kept for each item?

  Yes

  No

  N/A

• Is the plant checked for worthiness when first arriving on site?

  Yes

  No

  N/A

• What checks/ inspections are carried out? Are any of these recorded?

• Are all items fit for purpose i.e. is the right tool being used for the task?

  Yes

  No

  N/A

• What measures are taken to prevent unauthorised usage of all items of plant and machinery?

• Are spill kits provided in all Plant / Vehicles?

  Yes

  No

  N/A

• Are all items of plant & also vehicles fit for purpose & in a good condition, ie thread / tyre depths, wiper blades etc.

  Yes

  No

  N/A

WORKS PRACTICE, ENV

• Are works taking place at sufficient distances from water courses, drains?

  Yes

  No

  N/A

• If works are unavoidable & need to take place what control measures are detailed on the risk assessment?

• Are pedestrian walkways / roadways clear of any signs of mud & dirt?

  Yes

  No

  N/A

• Are local environment? People, Wildlife, going unaffected by works?

  Yes

  No

  N/A

• What exactly is the disturbance? NOISE LEVELS, DUST etc

• Are all COSHH items being stored safely & away from drains, watercourses?

  Yes

  No

  N/A

• Have all items that store fuel, plant, canisters etc have a sufficient spill protection in place?

  Yes

  No

  N/A

• Are waste materials being stored & transported correctly for nature of material, spoil, contaminated ground etc?

  Yes

  No

  N/A

CLOSE OUT

SIGNATURE

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