Title Page
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Contract Number
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Job Number
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Location
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Date of inspection
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Prepared by
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Team Supervisor
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Additional personnel on site
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Brief description of work activity
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Client
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Executive Summary
SSOW - T2A
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TSC Name
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TSC possess valid competency card
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TSC wearing appropriate armband
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TSC briefing book completed correctly
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Plant Equipment Materials (PEM) form completed
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TSC possess WON
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Correct PPE worn
TSC PIC - T2 Protection
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TSC Name
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TSC possess valid competency card
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TSC wearing correct armband
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TSC briefing booklet completed correctly
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Plant Equipment Materials (PEM) form completed
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T2 protection form completed correctly
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T-COD placed
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Red light placed in the five foot and clearly visible
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Suitable lookout protection placed (if required)
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TSC possess WON
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Correct PPE worn
T2-A Protection Arrangements
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Supervisor, TSC T2-A (PIC) & TSC working party proposed T2-A to be taken and this was agreed between these individuals?
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All staff in a POS before TSC makes any arrangements with the Signaller?
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From POS did TSC contact the Signaller and request a T2-A?
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TSC & Signaller agree the location of work?
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TSC & Signaller agree the lines to be affected?
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TSC & Signaller agree length of time required for T2-A?
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TSC & Signaller agree which signals are to be maintained at DANGER?
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Did TSC ensure the Signal to protect the work is placed to danger by the Signaller?
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Did TSC ensure Track Circuit shows CLEAR before the T-COD is placed on the line?
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Did TSC obtain Signaller's permission before placing T-COD on the line?
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Once T-COD placed - did TSC check with Signaller that the track circuit is now showing 'OCCUPIED'?
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Did TSC record authority number from the Signaller on Protection Arrangement form?
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TSC communicate to working party TSC authority number and projected hand back time?
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Working party TSC record authority number and projected hand back time on TSC briefing sheet?
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TSC confirm all working party are in a POS before handing back possession?
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Did TSC ask Signaller's permission to remove the T-COD?
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Did TSC confirm with Signaller T-COD removed and track showing CLEAR?
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Authority number repeated back and cancelled correctly?
PTS
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All staff possess valid PTS competency card or TVP?
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PTS staff received TSC brief and it is understood
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All staff wearing correct PPE
Lookout
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Lookout possess valid competency card
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Lookout wearing appropriate armband
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Lookout kit contain all items - flag/horn/whistle/light etc.
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Lookout mobile phone turned off
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Lookout(s) wearing correct PPE
Health and Safety
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Daily Risk Assessment (DRA) available and signed off by all relevant staff?
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All persons signed in/out of site?
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All site operatives inducted?
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Staff appropriately trained for the works they are carrying out?
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Method Statement & Risk Assessments (RAMS) available and signed by all relevant staff?
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Permit to Work in place?
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NI10 form available?
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Correct PPE being worn? (Behaviour/Compliance)
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Seat belts being worn when operating plant?
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Suitable site access and egress?
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Site security adequate? E.g. fencing, locked gates etc.
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Housekeeping adequate? (Slips, trips, falls, adequate lighting)
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Traffic management (signing / lighting / guarding) in place where applicable?
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Excavations safely guarded / battered back?
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Underground services identified? HSG47
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Weekly inspection of excavations completed?
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Overhead lines protected? GS6
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Is there an appropriate lift plan in place?
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Work at height properly planned?
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Aluminium tower fit for purpose and appropriate inspections carried out?
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Scaffolding fit for purpose and appropriate inspections carried out?
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Work on or near water properly planned?
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Measures in place to manage and control temporary works safely?
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Asbestos Refurbishment & Demolition Survey Report / Register available?
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Are toolbox talks being carried out weekly?
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Are good catches being recorded?
Kit & Equipment
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Weekly LOLER inspections completed?
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Weekly PUWER inspections completed?
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Thorough examination certs (TEC) available for all plant & equipment?
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Thorough examination certs (TEC) available for all lifting equipment?
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Daily plant inspections completed?
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CAT & Genny available and calibrated?
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Fire fighting equipment available?
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First Aid Kit (FAK) & Eye Wash stations available?
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Trained first aider on site and known to workers?
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Welfare facilities in place and adequate?
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Portable Appliance Testing (PAT) in place and up to date?
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Any hazards that require immediate intervention not stated above?
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Please state below any other observations identified on site
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Please state below any other observations identified on site
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Please state below any other observations identified on site
Environmental
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All hazardous substances stored correctly? e.g. drip trays
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All hazardous substances labelled correctly?
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Spill kits available?
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Waste disposed of correctly?
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Dust and noise controls in place?
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COSHH Assessments available?
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Please state any other observations identified on site
Quality
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Quality of works to an acceptable standard?
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Company insurance policy available and in-date?
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Company forms used in line with ISO procedures?
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Company procedures adhered too?
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Sub-contractors used for the works approved in line with company procedure?
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Verification sub-contractor has implemented a modern slavery policy and were not in place has agreed to work under ACPL policy?
Signature
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