Translink SHEQ Audit Inspection - SSOW T2-A Protection Arrangements

• Contract Number

• Job Number

• Location
  Address

• Date of inspection

  Date

• Prepared by

• Team Supervisor

• Additional personnel on site

• Brief description of work activity

• Client

• Executive Summary

• TSC Name

• TSC possess valid competency card

  Yes

  No

  N/A

• TSC wearing appropriate armband

  Yes

  No

  N/A

• TSC briefing book completed correctly

  Yes

  No

  N/A

• Plant Equipment Materials (PEM) form completed

  Yes

  No

  N/A

• TSC possess WON

  Yes

  No

  N/A

• Correct PPE worn

  Yes

  No

  N/A

TSC PIC - T2 Protection

• TSC Name

• TSC possess valid competency card

  Yes

  No

  N/A

• TSC wearing correct armband

  Yes

  No

  N/A

• TSC briefing booklet completed correctly

  Yes

  No

  N/A

• Plant Equipment Materials (PEM) form completed

  Yes

  No

  N/A

• T2 protection form completed correctly

  Yes

  No

  N/A

• T-COD placed

  Yes

  No

  N/A

• Red light placed in the five foot and clearly visible

  Yes

  No

  N/A

• Suitable lookout protection placed (if required)

  Yes

  No

  N/A

• TSC possess WON

  Yes

  No

  N/A

• Correct PPE worn

  Yes

  No

  N/A

T2-A Protection Arrangements

• Supervisor, TSC T2-A (PIC) & TSC working party proposed T2-A to be taken and this was agreed between these individuals?

  Yes

  No

  N/A

• All staff in a POS before TSC makes any arrangements with the Signaller?

  Yes

  No

  N/A

• From POS did TSC contact the Signaller and request a T2-A?

  Yes

  No

  N/A

• TSC & Signaller agree the location of work?

  Yes

  No

  N/A

• TSC & Signaller agree the lines to be affected?

  Yes

  No

  N/A

• TSC & Signaller agree length of time required for T2-A?

  Yes

  No

  N/A

• TSC & Signaller agree which signals are to be maintained at DANGER?

  Yes

  No

  N/A

• Did TSC ensure the Signal to protect the work is placed to danger by the Signaller?

  Yes

  No

  N/A

• Did TSC ensure Track Circuit shows CLEAR before the T-COD is placed on the line?

  Yes

  No

  N/A

• Did TSC obtain Signaller's permission before placing T-COD on the line?

  Yes

  No

  N/A

• Once T-COD placed - did TSC check with Signaller that the track circuit is now showing 'OCCUPIED'?

  Yes

  No

  N/A

• Did TSC record authority number from the Signaller on Protection Arrangement form?

  Yes

  No

  N/A

• TSC communicate to working party TSC authority number and projected hand back time?

  Yes

  No

  N/A

• Working party TSC record authority number and projected hand back time on TSC briefing sheet?

  Yes

  No

  N/A

• TSC confirm all working party are in a POS before handing back possession?

  Yes

  No

  N/A

• Did TSC ask Signaller's permission to remove the T-COD?

  Yes

  No

  N/A

• Did TSC confirm with Signaller T-COD removed and track showing CLEAR?

  Yes

  No

  N/A

• Authority number repeated back and cancelled correctly?

  Yes

  No

  N/A

PTS

• All staff possess valid PTS competency card or TVP?

  Yes

  No

  N/A

• PTS staff received TSC brief and it is understood

  Yes

  No

  N/A

• All staff wearing correct PPE

  Yes

  No

  N/A

Lookout

• Lookout possess valid competency card

  Yes

  No

  N/A

• Lookout wearing appropriate armband

  Yes

  No

  N/A

• Lookout kit contain all items - flag/horn/whistle/light etc.

  Yes

  No

  N/A

• Lookout mobile phone turned off

  Yes

  No

  N/A

• Lookout(s) wearing correct PPE

  Yes

  No

  N/A

• Daily Risk Assessment (DRA) available and signed off by all relevant staff?

  Yes

  No

  N/A

• All persons signed in/out of site?

  Yes

  No

  N/A

• All site operatives inducted?

  Yes

  No

  N/A

• Staff appropriately trained for the works they are carrying out?

  Yes

  No

  N/A

• Method Statement & Risk Assessments (RAMS) available and signed by all relevant staff?

  Yes

  No

  N/A

• Permit to Work in place?

  Yes

  No

  N/A

• NI10 form available?

  Yes

  No

  N/A

• Correct PPE being worn? (Behaviour/Compliance)

  Yes

  No

  N/A

• Seat belts being worn when operating plant?

  Yes

  No

  N/A

• Suitable site access and egress?

  Yes

  No

  N/A

• Site security adequate? E.g. fencing, locked gates etc.

  Yes

  No

  N/A

• Housekeeping adequate? (Slips, trips, falls, adequate lighting)

  Yes

  No

  N/A

• Traffic management (signing / lighting / guarding) in place where applicable?

  Yes

  No

  N/A

• Excavations safely guarded / battered back?

  Yes

  No

  N/A

• Underground services identified? HSG47

  Yes

  No

  N/A

• Weekly inspection of excavations completed?

  Yes

  No

  N/A

• Overhead lines protected? GS6

  Yes

  No

  N/A

• Is there an appropriate lift plan in place?

  Yes

  No

  N/A

• Work at height properly planned?

  Yes

  No

  N/A

• Aluminium tower fit for purpose and appropriate inspections carried out?

  Yes

  No

  N/A

• Scaffolding fit for purpose and appropriate inspections carried out?

  Yes

  No

  N/A

• Work on or near water properly planned?

  Yes

  No

  N/A

• Measures in place to manage and control temporary works safely?

  Yes

  No

  N/A

• Asbestos Refurbishment & Demolition Survey Report / Register available?

  Yes

  No

  N/A

• Are toolbox talks being carried out weekly?

  Yes

  No

  N/A

• Are good catches being recorded?

  Yes

  No

  N/A

Kit & Equipment

• Weekly LOLER inspections completed?

  Yes

  No

  N/A

• Weekly PUWER inspections completed?

  Yes

  No

  N/A

• Thorough examination certs (TEC) available for all plant & equipment?

  Yes

  No

  N/A

• Thorough examination certs (TEC) available for all lifting equipment?

  Yes

  No

  N/A

• Daily plant inspections completed?

  Yes

  No

  N/A

• CAT & Genny available and calibrated?

  Yes

  No

  N/A

• Fire fighting equipment available?

  Yes

  No

  N/A

• First Aid Kit (FAK) & Eye Wash stations available?

  Yes

  No

  N/A

• Trained first aider on site and known to workers?

  Yes

  No

  N/A

• Welfare facilities in place and adequate?

  Yes

  No

  N/A

• Portable Appliance Testing (PAT) in place and up to date?

  Yes

  No

  N/A

• Any hazards that require immediate intervention not stated above?

  Safe

  At Risk

  N/A

• Please state below any other observations identified on site

• Please state below any other observations identified on site

• Please state below any other observations identified on site

• All hazardous substances stored correctly? e.g. drip trays

  Yes

  No

  N/A

• All hazardous substances labelled correctly?

  Yes

  No

  N/A

• Spill kits available?

  Yes

  No

  N/A

• Waste disposed of correctly?

  Yes

  No

  N/A

• Dust and noise controls in place?

  Yes

  No

  N/A

• COSHH Assessments available?

  Yes

  No

  N/A

• Please state any other observations identified on site

• Quality of works to an acceptable standard?

  Yes

  No

  N/A

• Company insurance policy available and in-date?

  Yes

  No

  N/A

• Company forms used in line with ISO procedures?

  Yes

  No

  N/A

• Company procedures adhered too?

  Yes

  No

  N/A

• Sub-contractors used for the works approved in line with company procedure?

  Yes

  No

  N/A

• Verification sub-contractor has implemented a modern slavery policy and were not in place has agreed to work under ACPL policy?

  Yes

  No

  N/A

• Add signature

  Sign