TUM Health & Safety Site Assurance Audit

Conducted on

• Select date from calendar

  Date

Location

• Complete location on tracker
  Address

Contract Number

• What contract are the team currently working on?

Prepared by

• Name of person completing audit

Team Name

• Please record team members on site at time of audit

Documentation

• Has suitable Site Risk Assessment been conducted for the current operations?

  Yes

  No

  N/A

• Have all operatives signed the Risk Assessment or is there evidence of briefing?

  Yes

  No

  N/A

• Is there a Team Pack on site?

  Yes

  No

  N/A

• Does the Team Pack contain Risk Assessments, Method Statements and COSHH Assessments relevant to the works being undertaken and materials being used?

  Yes

  No

  N/A

• Are utility drawings available onsite, available, legible and in date? (ordinarily 28 days from date of issue)

  Yes

  No

  N/A

• Are HAVs Exposure Sheets being completed by all operatives?

  Yes

  No

  N/A

• Is there evidence of a daily plant check being carried out?

  Yes

  No

  N/A

• Please check what items of plant the team have on site and record the type of plant and its Plant Number.

• Are vehicles clean / tidy with all equipment and materials stored safely and without risk to health?

  Yes

  No

  N/A

• Is there a 'NO SMOKING' sticker in the vehicle?

  Yes

  No

  N/A

• Is there any evidence of non-compliance to the 'No Smoking' rules. such as cigarette butts?

  Yes

  No

• Is there any sign of damage or defects to the vehicle?

  Yes

  No

  N/A

• Is COSHH stored with appropriate labels and in approved containers?

  Yes

  No

  N/A

• Is there a site appropriate spill kit available for any environmental issues, fuel leaks etc

  Yes

  No

  N/A

Noticing & Competence

• Are NRSWA Noticing / TTRO's in place, displayed and valid?

  Yes

  No

  N/A

• Have Streetworks personnel and Plant Operators got the relevant NRSWA Cards and plant certificates available for inspection?

  Yes

  No

  N/A

• Is there a qualified First Aider on site?

  Yes

  No

  N/A

• What is the name of the First Aider?

• Is First Aid Kit Stocked suitably for the work being carried out and content in date?

  Yes

  No

  N/A

Fire

• Are Fire Extinguishers available, charged, in date and in useable condition? (N/A if not required)

  Yes

  No

  N/A

Welfare

• Are washing facilities available (including warm water, sink, soap & hand towels or hygienic hand wipes) available?

  Yes

  No

  N/A

• Are toilet facilities locally available?

  Yes

  No

  N/A

PPE

• For the following PPE options, please confirm they are in good condition and readily available when needed.

• Is all required PPE available and being worn if required? (Safety Helmets are mandatory)

  Yes

  No

  N/A

• Is PPE branded TRUST? (any non-trust branded items to be replaced)

  Yes

  No

  N/A

• Is flame retardant PPE being worn by those undertaking excavations?

  Yes

  No

  N/A

• Is dust suppression being used during cutting activities?

  Yes

  No

  N/A

Barriers & Work Area

• Are Traffic / Pedestrian Segregation Barriers fitted, supported by suitable bases, linked together and enclosing all sides of the site?

  Yes

  No

  N/A

• Is all the working equipment contained within the barriered work area (Including spoil)?

  Yes

  No

  N/A

• Is spoil stored in appropriate area(s)? (Environmental considerations ie away from water courses & drainage)

  Yes

  No

  N/A

• Is work area of a suitable size to operate safely?

  Yes

  No

  N/A

• Have all excavation works taken place as advised by the NJUG tree protection zone, as per guidance contained in the Team Pack?

  Yes

  No

  N/A

Traffic Management

• Is Traffic Management required?

  Yes

  No

• Is Traffic Management set up in accordance with Plan and assessment?

  Yes

  No

  N/A

• Is Traffic Management suitable for location and in good working condition?

  Yes

  No

  N/A

Signing Lighting & Guarding

• Are Courtesy Boards displayed and do they contain correct information?

  Yes

  No

  N/A

• Are Advanced warnings signs in correct sequence, distance and suitably fixed to prevent being blown down or out of position?

  Yes

  No

  N/A

• Is the natural light, or temporary lighting, adequate for the works being carried out?

  Yes

  No

  N/A

Footways

• Are alternative pedestrian arrangements required? (i.e. Pedestrian re-routing, narrowing of walkway, road crossing)

  Yes

  No

• Are footway covers / boards in good condition, appropriately fitted and free of trip hazards?

  Yes

  No

  N/A

• Are pedestrian diversion routes clearly marked, visible, and correctly fitted?

  Yes

  No

  N/A

• Are footway closed signs in use and appropriately positioned (near dropped kerbs/road crossings)?

  Yes

  No

  N/A

• Is the pedestrian walkway the correct width? (At least 1.2m)

  Yes

  No

  N/A

• Are carriageway trench boards suitable and fixed where in use?

  Yes

  No

  N/A

HSG47

• Are cable avoidance tool and genny readily available?

  Yes

  No

  N/A

• Is CAT and genny equipment calibrated and in good working order?

  Yes

  No

  N/A

• Please input the calibration/service date.

  Date

• Are operatives using CAT and genny trained and competent?

  Yes

  No

• Are utility markings suitable and clearly visible?

  Yes

  No

  N/A

• Are insulated tools being used where required?

  Yes

  No

  N/A

• Has a CAT Data been downloaded?

  Yes

  No

  N/A

Other Plant & Equipment (excluding CAT and Genny)

• Is other Plant and Equipment required on site at time of audit?

  Yes

  No

  N/A

• Is Plant / Equipment in good operational order and being used correctly (clean, usable, beacons, safety pins etc)?

  Yes

  No

  N/A

• If Stihl Saws or Hand Held Grinders are on site, are handles and guards fitted?

  Yes

  No

  N/A

House Keeping

• Are excavated materials removed from the side of the excavation?

  Yes

  No

  N/A

• Are contaminated materials stored away from grass verge?

  Yes

  No

  N/A

• Are tools being used on site stored safely without risk of causing trips??

  Yes

  No

  N/A

• Are materials (reinstatement/excavated) stored correctly within the confines of the site/compound?

  Yes

  No

  N/A

• Are plant, fuelled tools and fuel cans being stored on drip trays/plant pads?

  Yes

  No

  N/A

• Is the site swept clean after completion?

  Yes

  No

  N/A

• Is all plant attended whilst running?

  Yes

  No

  N/A

• Are plant and vehicle keys stored outside of the vehicle when not in use?

  Yes

  No

  N/A

• Are ducts, cable, other materials stored correctly / safely?

  Yes

  No

  N/A

• Is there sufficient protection to prevent falls from height? (including on vehicles where required)

  Yes

  No

  N/A

Defects

• Are there any Streetworks Defects / Issues that could result in FPN's, that have not been rectified at the completion of Site Visit?

  Yes

  No

• Please ensure you have informed all relevant parties of the defect(s) identified.

Good Practice

• Are there any exceptionally good safety behaviours or standards of work being exhibited?

  Yes

  No

• Who would you like to highlight?

  Contractor / Gang

  Individual

  Other

• If answer is other, please specify.

• Please name the group / individual you would like to highlight

• Please give a description of the practice you have observed and would like recognised.

All personnel conducting site audits and inspections must ensure that all findings are recognised by the lead contractor representative on site (they do not have to agree the findings but must acknowledge your audit).

• Contractor Signature of recognition of findings

  Sign

• Auditor Signature

  Sign

• Please ensure all actions have been assigned where required.