Title Page

  • Conducted on

  • Reporter's Name & Company Represented:

  • Location

INSPECTION DETAILS

  • Reporter Job Title:

  • 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

  • Has Inspection Lead had to order the suspension of works?

Quality and Safety

1.0 Site Safety

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

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

  • Do the team have access to adequate welfare facilities?

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

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

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

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

  • Are vibrating tools maintained in good working order?

  • Is all Vibrating Equipment assessed and tagged?

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

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

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

2.0 Vehicles

  • Do vehicles have working beacons and approriate chevron markings?

  • Are vehicles tidy and clean?

  • Are vehicles parked safely & securely without causing obstruction?

3.0 Work Pack & Site Documentation

  • Is a legible copy of the work pack/order on site and understood?

  • Are Site Specific Risk assessments in place?

  • Have suitable Utility Plans been issued and available on site?

  • Have works been undertaken as planned?

4.0 Works Practices / H&S

  • Are safe digging practices and HSG47 being adhered to?

  • Are all appropriate buried services identified and traced?

  • Are all identified buried services visibly marked?

  • Are excavations stable and free from excess water?

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

  • Is work site tidy and free from tripping hazards?

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

5.0 NRSWA

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

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

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

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

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

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

  • Do information boards display appropriate notification and contact numbers?

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

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

  • CSCS accreditation card available, If Applicable?

Cabling In Progress

9.0 External Cabling (General)

  • Cable routes identified and verified as correct?

  • Required H&S practices adhered to during cable installation?

  • Cable installation specification adhered to?

  • Cable management and labelling as per specification?

  • Cable test records taken?

  • All cabling waste cleared from site and disposed of correctly?

  • Back rope installed?

10.0 OPTICAL FIBRE SPLICING (GENERAL)

  • Splice marked / labelled?

  • Seals & heatshrinks fitted correctly?

  • Tubes / Fibres numbered?

  • Spliced to design?

  • Desicant packs in place?

  • Fibres in cassettes cleaned?

  • Fibres correctly in cassettes?

  • In /Out cables labelled correctly?

  • Joint secured to bearers?

  • Is pit / box adequate for joint size?

  • Vertical stress loop every 10m?

  • Splice Tray fitted/labelled correctly?

CLOSE OUT

  • Signature:

Sheet

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.