Title Page

  • Conducted on

  • Prepared by

  • Team

  • Location
  • Activity being undertaken on site

  • SDO (if applicable)

General Safety and Documentation

  • Is the work activity covered by relevant RAMS, and if so, are they available on site?

  • Has an accurate Site Specific Risk Assessment been completed and signed before commencing work?

  • Is there a valid Permit to Work in place, if required?

  • Accreditations in date and relevant to the task being undertaken? (accreditations can be accessed through ConnectED)

  • Accreditation Requirements
  • Accreditation required?

  • Reason?

  • Who requires the accreditation(s)?

  • Are operatives wearing the correct PPE for the activity being undertaken, and is it in good working condition? (Safety helmets to be swapped out after 3 years, regardless of condition. Check stamp on the inside of the helmet). Create actions for non compliance.

  • If an operative is missing PPE or is wearing PPE that isn't fit for purpose then please list the PPE required, the size, and the operative who requires it.

  • PPE Requirements
  • List PPE, size, and operative who requires it.

Vehicle

  • Do you want to answer the Vehicles questions?

  • Works vehicle parked safely with regards to other road users and pedestrians?

  • Is the works vehicle road worthy? (check tyres, lights, brakes, mirrors etc)

  • Report any defects and raise with Fleet Manager.

  • Vehicle fitted with functional amber flashing beacon and reflective chevrons?

  • Report any defects and raise with Fleet Manager.

  • Is the vehicle carrying sufficient SLG equipment? (enough for at least short duration work up to 60 minutes. Check red book if unsure)

  • Make sure to place an order for any missing SLG equipment.

  • Is a fire extinguisher being carried on the vehicle and is it within inspection date?

  • Are tools and equipment stored correctly in the vehicle and secured to avoid damage?

  • Are tools and equipment in good condition, inspected and calibrated if required?

  • Take any tools or equipment out of service if they're not fit for purpose or require inspection/calibration.

Site Set-up

  • Do you want to answer the Site Set Up questions?

  • Do operatives have access to the Red Book (Safety at Street Works and Roads Works) on site?

  • Do operatives hold an in date NRSWA O1 accreditation?

  • Site maintained in a tidy condition, tools and materials stored safely in the working space or works vehicle?

  • General site set up in good order and follows the Red Book?(signing, lighting, guarding, minimum footpath and or carriageway widths maintained, temporary walkways, correct traffic control method etc)

  • All vehicles positioned safely as per the code of practice?

  • Overall, has the site been made safe for operatives, pedestrians, and road users?

Hygiene / Welfare

  • Do you want to answer the Hygiene and Welfare questions?

  • Is a fully stocked First Aid kit available on site?

  • Is a Sharps bin available on site? (discarded needles, fibre shards)

  • Are wash facilities available on site?

  • Make sure to order any missing hygiene/welfare items.

Working in the underground network

  • Do you want to answer questions relating to accessing or working within chambers?

  • Are there enough fully functional GDU's available on site? (check calibration)

  • Why aren't there enough GDU's on site? Create an action if anyone is missing a GDU.

  • Is the correct cover removal tool available and on site? (lifter 5A, roller bar, hydraulic lifter, T keys as last resort)

  • Why is the correct cover removal tool not available on site? Create an action if anyone is missing a cover removal tool and state what type.

  • Has a gas test been completed before entering the UG network and has the chamber been opened correctly? (crack the lid, 2 beeps)

  • Have all open chambers been correctly signed and guarded in order to keep operatives and the public safe?

  • Is continuous gas monitoring being observed?

  • Are Operatives aware of hazards related to chambers containing water? (Weil's disease, contamination, biohazards etc)

  • Are Operatives aware of the risk of discarded used syringes and do they have the equipment to deal with them? (Operatives are in their right to choose not to handle sharps, even if they have the equipment to deal with them. In all cases, sharps must be reported to management).

  • Is the work being carried out inline with the TI Engineering guide and relevant CP documents? (If no, make sure to raise a network defect using the Network Audit template).

  • Please see attached CP10 document for support when assessing the quality of work being completed within the Openreach Network. If any found defects cannot be rectified on the spot, make sure to raise them using the Network Audit template.

Working in the Overhead Network

  • Do you want to answer questions relating to accessing and working on the Overhead Network?

Pre-climb Check

  • Has a pre-climb check been correctly completed before starting work?

Sign Off

  • Provide details of any comments made or concerns raised by operatives on site.

  • Inspector additional comments. (create action if required)

  • Sign to confirm the inspection is an accurate record of the findings.

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.