Title Page

  • Completed forms are to be kept readily available (preferably on site) for the duration of construction works, after which time shall form part of the CDM Health & Safety File.

  • Sensible Monitoring Audit Completed By:

  • Site Manager:

  • Contract Number:

  • Project Title:

  • Conducted on

General

  • Any H&S actions identified shall be entered onto Audit / Inspection Action Log and brought to the urgent attention of the appropriate personnel as soon as possible. Contractor / Project Manager to be notified of actions required / taken.

  • 1) Is there a Method Statement / Risk Assessment available on site for the activity?<br>a) Has it been briefed out and signed for?

  • Comments:

  • Attach any images relevant to question 1 here.

  • 2) Has the temporary design been briefed out to all concerned and regular inspection implemented?

  • Comments:

  • Attach any images relevant to question 2 here.

  • 3) Are the emergency procedures adequate and do all personnel understand them?<br>a) Have foreseeable emergencies been identified?

  • Comments:

  • Attach any images relevant to question 3 here.

  • 4) Have all Operatives been inducted to Project and received EUSR training?

  • Comments:

  • Attach any images relevant to question 4 here.

  • 5) Are all operatives competent to perform the task?<br>(Check CITB, CSCS Cards, Training Records etc.) Confined Spaces entry training, breathing apparatus medically fit.

  • Comments:

  • Attach any images relevant to question 5 here.

  • 6) Is there a process in place in the event of unforeseen / change in ground condition?<br>i.e. contaminated ground, running sand, high water table, mass concrete etc

  • Comments:

  • Attach any images relevant to question 6 here.

  • 7) Is the correct PPE for the task being worn?<br>(Check condition, age, storage, training)

  • Comments:

  • Attach any images relevant to question 7 here.

  • 8) Is the site tidy and free from trip hazards and is there safe access and egress available for all?

  • Comments:

  • Attach any images relevant to question 8 here.

  • 9) Are the welfare facilities adequate and is there appropriate first aid provision on site?<br>(Numbers of Appointed Persons / First Aiders, Location / Contents of Kit)

  • Comments:

  • Attach any images relevant to question 9 here.

  • 10) Has adequate fencing been put in place around excavations and is appropriate signage posted to warn of dangers?

  • Comments:

  • Attach any images relevant to question 10 here.

  • 11) Is a system in place to deal with surplus water, which may be present in the excavation and surrounding ground?

  • Comments:

  • Attach any images relevant to question 11 here.

  • 12) Who is responsible for inspecting the condition of the excavations, are these inspections recorded?

  • Comments:

  • Attach any images relevant to question 12 here.

  • 13) Is there safe access and egress to all areas of the excavations?

  • Comments:

  • Attach any images relevant to question 13 here.

  • 14) Is there sufficient space available around the excavation to all for plant, materials, vehicles and persons to move around safely?<br>a) Does the layout of the site comply with the given plot plan?

  • Comments:

  • Attach any images relevant to question 14 here.

  • 15) Does the method statement include specific items of lifting equipment to be used during lifting operations and are these adhered to?

  • Comments:

  • Attach any images relevant to question 15 here.

  • 16) Are all slings, shackles, hooks, chains etc. in good condition and do they have the appropriate certification?

  • Comments:

  • Attach any images relevant to question 16 here.

  • 17) Do all items of plant on site undergo regular inspections and checks by the operators; are these recorded?<br>e.g. excavators, cranes, side booms etc.

  • Comments:

  • Attach any images relevant to question 17 here.

  • 18) Are "Safe Havens" in use during lifting operations in the shaft?

  • Comments:

  • Attach any images relevant to question 18 here.

  • 19) Has the operation been class as "Confined Space" working?<br>a) If so, are persons competent to enter and are there appropriate emergency evacuation procedures?

  • Comments:

  • Attach any images relevant to question 19 here.

  • 20) Has a system of communication been agreed between those inside the confined space and those outside?<br>

  • Comments:

  • Attach any images relevant to question 20 here.

  • 21) Is there a "Tally" system or similar to record who is in the tunnel and how long they have been in there?

  • Comments:

  • Attach any images relevant to question 21 here.

  • 22) Is the confined space checked for a toxic atmosphere, oxygen deficient atmosphere, flammable gas and water?<br>a) Are atmospheric tests carried out at the start of every shift and during activities?

  • Comments:

  • Attach any images relevant to question 22 here.

  • 23) Is there sufficient lighting available on site for overall illumination as well as task specific lighting?

  • Comments:

  • Attach any images relevant to question 23 here.

  • 24) Has sufficient air movement been provided and fume extraction?

  • Comments:

  • Attach any images relevant to question 24 here.

  • 25) Are any vehicle / plant exhaust fumes likely to enter the confined space?

  • Comments:

  • Attach any images relevant to question 25 here.

  • 26) Has adequate stale air / fume extraction been provided?

  • Comments:

  • Attach any images relevant to question 26 here.

  • 27) Is breathing apparatus checked / tested / inspected prior to entry?<br>(Recorded)

  • Comments:

  • Attach any images relevant to question 27 here.

  • 28) Are atmospheric monitors within their calibration date, batteries checked, tested prior to entry?

  • Comments:

  • Attach any images relevant to question 28 here.

  • 29) If required, are there an adequate number and type of fire extinguishers on site and are they in appropriate locations?

  • Comments:

  • Attach any images relevant to question 29 here.

Sign Off Audit

  • Print Name:

  • Signature:

  • Project Manager Name:

  • Signature:

  • Designation:

  • Select date

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.