Title Page
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Full name of Contractor observed
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Exact Location (including postcode)
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Type of work being undertaken
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Prepared by
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Job Title
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Date Checklist Undertaken
Site Safe Systems
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Appropriate barriers and site signage in place
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Site tidy and materials are stored safely
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Working areas and walkways are level and free from trip hazards & obstructions
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Appropriate PPE being used e.g. safety boots, gloves, hardhat
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Work area adequately lit
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Flammable materials stored securely and separately
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First aid provision available
Protecting the public
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Work areas clearly and securely segregated
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Adjacent public access areas are level and no trip hazards
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Emergency escape routes are not compromised
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Unattended plant, ladders & equipment are immobilised to prevent unauthorised use
Manual handling
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Mechanical devices are used whenever possible
Ladders
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Ladders in good condition and appropriate for task
Scaffolds
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Valid certificate on scaffold
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Guard rails and toe boards have been installed
Roof Work
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Harnesses are available and used where appropriate
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Adequate edge protection to stop people or items falling
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Equipment such as MEWPs used by competent person(s) in an agreed location
Electricity
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RCDs are provided where mains voltage has to be used
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Cables and leads. Or trailing
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Portable electrical equipment tested and tagged and looks in good condition
Vehicles on Site
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Pedestrian and vehicle routes are separate and clearly marked
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Contractors' vehicles are parked in agreed locations
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Completed forms to be returned to the appropriate Health and Safety Team:
North Region
South Region
West Region