Utilities Management Safety Tour

• undefined

• Conducted on

  Date

• Auditor

• Auditee

• Vehicle Registration

• Location
  Address

Inspection

• Is there safe access / egress to the work area?

  Yes

  No

  N/A

• Detail reason for N/A.

• Are welfare facilities made available to operatives? (local site or services etc.)

  Yes

  No

  N/A

• Detail reason for N/A.

• Are the measures to control machine interface suitable and sufficient; for example, exclusion zones, Barriers and Banksman etc?

  Yes

  No

  N/A

• Detail reason for N/A.

• Are plant operators (if applicable) trained for the machines in use? (evidence of NPORS / CPCS)

  Yes

  No

  N/A

• Detail reason for N/A.

• Are safe digging practices being observed as per HSG 47 including in date CAT & Genny?

  Yes

  No

  N/A

• Detail reason for N/A.

• Has the site Utilities Specific Risk Assessment MCL-FR-0053 been completed?

  Yes

  No

  N/A

• Detail reason for N/A.

• Are MCL employees wearing the correct PPE, in line with site rules and/or the task risk assessment?

  Yes

  No

  N/A

• Detail reason for N/A.

• Work vehicle suitably loaded and clean?(e.g. not overweight or unstable)

  Yes

  No

  N/A

• Detail reason for N/A.

• Is winch and rollers present and in use where applicable? (Track shall never be used to pull cable)

  Yes

  No

  N/A

• Detail reason for N/A.

• Is a welding tent being used if applicable?

  Yes

  No

  N/A

• Detail reason for N/A.

• Electrofusion and Generator calibration/servicing in date?

  Yes

  No

  N/A

• Detail reason for N/A.

• Fire extinguisher available and in date?

  Yes

  No

  N/A

• Detail reason for N/A.

• First Aid Kit and Eye Wash in Date?

  Yes

  No

  N/A

• Detail reason for N/A.

• NERS, GIRS, WIRS Folder Present and in date?

  Yes

  No

  N/A

• Detail reason for N/A.

• Submersible pump present and in date PAT?

  Yes

  No

  N/A

• Detail reason for N/A.

• G / top Loading clamp in date?

  Yes

  No

  N/A

• Detail reason for N/A.

• HACH Kit in Date?

  Yes

  No

  N/A

• Detail reason for N/A.

• Is the BA kit calibration in date?

  Yes

  No

  N/A

• Detail reason for N/A.

• Comark digital pressure test gauge available and in date?

  Yes

  No

  N/A

• Detail reason for N/A.

• Gasco-Seeker available & in date?

  Yes

  No

  N/A

• Detail reason for N/A.

• LP & MP Bullhorns available & in date?

  Yes

  No

  N/A

• Detail reason for N/A.

• Radcom data logger available & in date?

  Yes

  No

  N/A

• Detail reason for N/A.

• 110 volt extension cable available, PAT Tested & free from damage?

  Yes

  No

  N/A

• Detail reason for N/A.

• Additional Observations

Additional Observations

• Additional Observations

  Compliant

  Non-Compliant

  N/A

Signed

• Auditor

  Sign

• Auditee

  Sign